In October 2009, a team led by Vincent C. Lombardi of the Whittemore Peterson Institute reported the presence of a recently discovered virus, XMRV, in 67% of the blood samples from 101 American patients with chronic fatigue syndrome (CFS). XMRV had previously been linked to some cases of prostate cancer.This sparked intense interest amongst many people and much discussion. But in January this year, Erlwein et al reported that they did not find any evidence of XMRV in the blood of 186 British CFS patients (my post).Now, a second British study has appeared, and the results are also negative. The paper is Groom et al's Absence of xenotropic murine leukaemia virus-related virus in UK patients with chronic fatigue syndrome. They found no XMRV in 170 British CFS patients or 395 healthy controls. VirologyBlog has an excellent summary of the latest paper.In order to help people interested in this topic, I've put together a quick summary of all the data on XMRV infection in humans. If I've left anything out or made any mistakes, let me know in the comments. I'll try to keep this list up to date with every new publication - because there are sure to be plenty more.Overall, the most striking thing about these results is the national differences. XMRV has been detected in 67% of American CFS patients, in 10-25% of American prostate cancer cases, and in 3-4% of healthy Americans. By contrast, in Germany, Britain and Ireland, it's only been detected in 2 Germans, out of a grand total of 1288 European people who have been tested so far using a variety of methods. The situation elsewhere is unclear; one study claimed to detect XMRV in 1.5% of healthy Japanese blood donors but this is unpublished, and the methodology is unclear.Other than that, it's not clear what's going on here, and it seems to me that it would be premature to conclude anything about XMRV and CFS (or, indeed, cancer) at this stage.*Published Papers - CFS1. Lombardi et al 2009Patients: "CDC Fukuda Criteria and the 2003 Canadian Consensus Criteria... presenting with severe disability... their diagnosis of CFS is based upon prolonged disabling fatigue ... cognitive deficits and reproducible immunological abnormalities ... impaired exercise performance with extremely low VO2 max measured on stress testing."Origin: USAMethod A: PCR of DNA from PBMCsResult: 68 of 101 patients (67%), 8 of 218 controls (3.7%)Method B: PBMC reactivity to anti-MLVp30Gag antibodiesResult: 19 of 30 patients (63%), 0 of 16 controls (0%)Method C: Plasma immunoreactivity to SFFV-EnvResult: 9 out of 18 patients with XMRV, 0 out of 7 controls2. Erlwein et al 2010Patients: CDC Fukeda criteria "markedly unwell. Few were working, and 19% were members of patient support groups for CFS/ME... The levels of fatigue in this sample were high ... as were levels of disability"Origin: London, UKMethod: PCR of DNA from whole bloodResult: 0 out of 186 patients (0%)3. Groom et al 2010Patients: CDC Fukeda criteriaOrigin: Bristol, Dorset, London, Birmingham, Norfolk and Epsom, UKMethod A: PCR of gDNA from PBMCsResult: 0 of 48 patients (0%)Method B: PCR of gDNA, cDNA, or both from PBMCsResult: 0 out of 142 patients (0%), and 157 controls (0%)Method C: Serum immunoreactivity to XMRVResult: 1 out of 160 patients; 25 out of 395 controls; but positives were not considered specific to XMRV, as they also reacted to and neutralized other viruses.Published Papers - Prostate Cancer4. Urisman et al 2006Patients: Familial Prostate CancerOrigin: Cleveland, USAMethod: PCR on tumor cell DNAResult: 9 of 86 (10.4%); associated with R462Q QQ genotype5. Schlaberg et al 2009Patients: Prostate CancerOrigin: Columbia University Medical Center, USAMethod A: PCR on tumor cell DNAResults: 14/223 prostate cancer patients (6.2%), 2/101 non-cancer prostate controls (2.0%). Not associated with R462Q QQ genot... Read more »
Harriet Groom, et al. (2010) Absence of xenotropic murine leukaemia virus-related virus in UK patients with chronic fatigue syndrome. Retrovirology. info:/
A discussion of a medical analysis of several Egyptian mummies including 'King Tut'... Read more »
Hawass Z, Gad YZ, Ismail S, Khairat R, Fathalla D, Hasan N, Ahmed A, Elleithy H, Ball M, Gaballah F.... (2010) Ancestry and pathology in King Tutankhamun's family. JAMA : the journal of the American Medical Association, 303(7), 638-47. PMID: 20159872
A lot of medication gets misused, as is the right expression, meaning not used for the intention or indication it was developed for in the first place. This reminded me of one of my first publications on the abuse of anticholinergics.
From case reports it appears that quetiapine is sought after for recreational use and inappropriate [...]
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Fischer, B., & Boggs, D. (2010) The role of antihistaminic effects in the misuse of quetiapine: A case report and review of the literature. Neuroscience , 34(4), 555-558. DOI: 10.1016/j.neubiorev.2009.11.003
I came across this paper by Rowland Hazard and colleagues amongst a whole lot of papers lying on my desk (those of you who’ve seen my desk will understand what a momentous occasion it was to find something there!). It describes a very useful finding from a study the group conducted on outcome measurement.
There [...]... Read more »
Hazard RG, Spratt KF, McDonough CM, Carayannopoulos AG, Olson CM, Reeves V, Sperry ML, & Ossen ES. (2009) The impact of personal functional goal achievement on patient satisfaction with progress one year following completion of a functional restoration program for chronic disabling spinal disorders. Spine, 34(25), 2797-802. PMID: 19910869
Birds are important in the natural history of Influenza and flu, but there is another character besides us humans. The pigs.
Our knowledge of Influenza in pig dates back to at least 1918 when it was observed that they could also catch the flu during a time when the human flu caused an uneven pandemic. In [...]... Read more »
Olsen, C. (2002) The emergence of novel swine influenza viruses in North America. Virus Research, 85(2), 199-210. DOI: 10.1016/S0168-1702(02)00027-8
Landolt, G., & Olsen, C. (2007) Up to new tricks – A review of cross-species transmission of influenza A viruses. Animal Health Research Reviews, 8(01), 1. DOI: 10.1017/S1466252307001272
Some of us have been just waiting for the moment when barefooting or vff'ing would make it through to the mainstream. THis seems to have happened recently on the cover of nature, with DE Lieberman's research in praise of the unshod. The formal article title is "Foot strike patterns and collision forces in habitually barefoot versus shod runners" ... Read more »
Lieberman, D., Venkadesan, M., Werbel, W., Daoud, A., D’Andrea, S., Davis, I., Mang’Eni, R., & Pitsiladis, Y. (2010) Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, 463(7280), 531-535. DOI: 10.1038/nature08723
What a great study.The authors analyzed the television viewing habits of 2,037 children between the ages of 0 and 12 back and the outcome they were interested in was BMI. Parents were given diaries where they tracked among other things the format of the television their children watched. Formats could be educational viewing on broadcast or cable (shows like Sesame Street), education viewing on DVD or video (same shows as on cable but without advertisements), children's entertainment viewing on DVD or video (such as Disney movies or advertisement free television cartoons), children's entertainment viewing on broadcast or cable, and lastly general audience viewing on broadcast or cable. Researchers also divided the children into groups below the age of 7 and above as those below 7 have been shown to be unable to differentiate truth from advertising. They controlled for many variables. Physical activity, gender, age, ethnicity, sleep duration, eating in front of the television, mother's BMI, and mother's education. The results were striking. For children younger than 7 each hour of commercial viewing was associated with a 0.11 increase in BMI scores after controlling for all of the aforementioned variables. For children older than 7, when controlled for all of the aforementioned variables and also the child's baseline BMI, again commercial viewing was once again significantly associated with increased risk of obesity.The fact that the researchers controlled for so many variables and perhaps most importantly to challenging conventional dogma, physical activity, demonstrated to them that it's not what television is keeping kids away from (active play) that leads to obesity but rather that the viewing itself is causal for obesity and more specifically, the viewing of commercial advertisements. Why might that be? The authors point out that children younger than 5 see an average of 400 television commercials each year (or 30 hours worth), during Saturday morning cartoons they see an average of 1 food ad every 5 minutes, and that 95% of foods advertised on television were of poor nutritional value. Equally frightening? They point out that the average first-grade child can identify over 200 brands.So what does all this mean? It means it's probably not about how much they're watching, it's about what they're watching and while efforts to get kids off the couch to play certainly can play a role in reducing the burden of childhood obesity, it's not the playing that helps, it's getting them out of marketers' cross hairs. Given that to date there has not been a single public health intervention that has led to long term reductions in screen-time, shouldn't we instead be focusing our efforts on enacting legislation to ban television based food marketing to children in general?Zimmerman, F., & Bell, J. (2009). Associations of Television Content Type and Obesity in Children American Journal of Public Health, 100 (2), 334-340 DOI: 10.2105/AJPH.2008.155119
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Zimmerman, F., & Bell, J. (2009) Associations of Television Content Type and Obesity in Children. American Journal of Public Health, 100(2), 334-340. DOI: 10.2105/AJPH.2008.155119
Researchers at MIT have identified a gene, DISC1, implicated in the neural and behavioral psychopathology of schizophrenia.... Read more »
Mao Y, Ge X, Frank CL, Madison JM, Koehler AN, Doud MK, Tassa C, Berry EM, Soda T, Singh KK.... (2009) Disrupted in schizophrenia 1 regulates neuronal progenitor proliferation via modulation of GSK3beta/beta-catenin signaling. Cell, 136(6), 1017-31. PMID: 19303846
You might have seen news reports about a recent study showing that religious people are no healthier than non-religious. The cynical among you might be wondering what on Earth's going on here, given that other studies have shown the opposite! A classic example of scientists proving whatever they want to, perhaps?Well, no. There's a good reason that this study has found something different, and that's because it's not asking quite the same question.You see, working out the relationship between religion and health is actually quite complicated. If you take the straightforward approach the answer is clear: religious people are unhealthier and die younger than the non-religious.The reason for that is obvious. Religious people tend to be poorer and less well educated. As a result, most studies try to work out whether religious people are healthier after adjusting for these differences.So the key question boils down to this: which differences should you adjust for? Your decision on this will affect the answer you get.Most studies adjust for basic demographic factors. Older people and women are more likely to be religious, and both these affect your chances of heart attacks. Most studies also adjust for education and income level.The rationale is our old friend, the arrow of causality. While being older might cause you to be more religious, being religious doesn't cause you to be older!But there are also a host of lifestyle factors that make heart disease more likely (smoking, lack of exercise, overeating). Here's where it starts to get more difficult, because religion could definitely cause you to be a nonsmoker.Many studies adjust for these lifestyle factors. But you can go a step further - and that's what they did in this study.Lifestyle contributes to heart disease by affecting things like your cholesterol levels and blood pressure, and by making you more likely to be diabetic. If you adjust for all of these, then you are really getting down to a nitty gritty question.And so the question they were asking in this study was really very specific. They wanted to know if, apart from all the physical things that could link religion to heart disease, there is some other, unexplained factor at work.So what's this study about, then?With all that in mind, let's take a quick look at this study. What they did was follow about 5,000 Americans recruited as part of another study and chosen to be ethnically diverse and regionally representative. They recorded heart attacks and strokes over 4 years.As expected, nonreligious people were much more healthy than the religious. They had lower blood pressure, were leaner, and were less likely to be diabetic. They were, however, more likely to be smokers.The effects of this could be detected in their organs. The arteries of religious people were more damaged and their hearts were enlarged.But the nonreligious also better educated, more likely to be white or Chinese, and more likely to be men. All of these would affect your lifestyle.So they adjusted for age, sex, race, education and income, like many other studies before have done. Crucially (and unlike other studies), they also adjusted for blood pressure, diabetes, obesity, and cholesterol.What they found is shown in the figure. After statistically adjusting for all the common physical factors that are linked to heart disease, there was no effect of religion.In other words, whatever effect religion has on health (for good or bad), it must do it by affecting known risk factors in some way.I guess that's not too surprising. But other studies have found that psychological factors can lead to heart disease. This study suggests that these psychological factors aren't significantly affected by religion.The really interesting thing is...One last thing - and this is what I thought was the really mind-blowing result from this study.They found that religious people smoked less. This was one of only two lifestyle factors that remained after they adjusted for all the demographic differences between the religious and non-religious (age, gender, race, education and income).That's something that's commonly observed, and it may be because religion provides social pressure and support to help people quit.But the study also found that religious people were fatter (again, after adjusting for demographic factors). The effect was large - religious people were 50-60% more likely to be obese.That's a result that has been seen in other studies, but is altogether more difficult to explain! Donald Lloyd-Jones, the study lead, put it like this:"The obesity story is interesting, and we tried a lot of different ways to get it to go away—looking at social, demographic, and psychosocial factors—and really didn't see any clear explanation for it," said Lloyd-Jones. "So we're left with this observation, and we're not really sure what's the cart and what's the horse. We don't really know if there is something about religious participation that leads to obesity, or if it's the other way around, and that heavier people might seek out religious and spiritual experiences because of things like stigmatization."Feinstein M, Liu K, Ning H, Fitchett G, & Lloyd-Jones DM (2010). Burden of cardiovascular risk factors, subclinical atherosclerosis, and incident cardiovascular events across dimensions of religiosity: the multi-ethnic study of atherosclerosis. Circulation, 121 (5), 659-66 PMID: 20100975 This article by Tom Rees was first published on Epiphenom. It is licensed under Creative Commons.
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Feinstein M, Liu K, Ning H, Fitchett G, & Lloyd-Jones DM. (2010) Burden of cardiovascular risk factors, subclinical atherosclerosis, and incident cardiovascular events across dimensions of religiosity: the multi-ethnic study of atherosclerosis. Circulation, 121(5), 659-66. PMID: 20100975
For most of my clinical working life the focus in pain management has been on factors that identify people who have a high risk of developing long-term disability associated with their pain. The tide is turning, though, and increasingly we’re seeing papers published that look instead at treatment provider attitudes, beliefs and behaviours as [...]... Read more »
Bowey-Morris, J., Purcell-Jones, G., & Watson, P. (2010) Test-Retest Reliability of the Pain Attitudes and Beliefs Scale and Sensitivity to Change in a General Practitioner Population. The Clinical Journal of Pain, 26(2), 144-152. DOI: 10.1097/AJP.0b013e3181bada3d
by Nestor Lopez-Duran PhD in Child-Psych
Last week after writing about the DSM-V “Temper Dysregulation Disorder with Dysphoria,” I received several emails asking my opinion regarding the proposed merger of autism and Asperger’s disorder into a single ’spectrum’ category. This change has clearly generated some significant political debate in the media and the blogosphere, with some in favor of the change [...]... Read more »
Klin, A., Pauls, D., Schultz, R., & Volkmar, F. (2005) Three Diagnostic Approaches to Asperger Syndrome: Implications for Research. Journal of Autism and Developmental Disorders, 35(2), 221-234. DOI: 10.1007/s10803-004-2001-y
How simple is it to treat somnambulism? The recent popularity of the recorded alter-ego of 'Sleep-Talking Man' has me looking at what research has been done.... Read more »
Harris M, & Grunstein RR. (2009) Treatments for somnambulism in adults: assessing the evidence. Sleep medicine reviews, 13(4), 295-7. PMID: 19046651
Siddiqui F, Osuna E, & Chokroverty S. (2009) Writing emails as part of sleepwalking after increase in Zolpidem. Sleep medicine, 10(2), 262-4. PMID: 19059805
Last week @F1000 (on Twitter) alerted me to an interesting discussion at F1000 on a paper in Science, that linked Chronic fatigue syndrome (CFS) to a newly discovered human virus XRMV [1. This finding was recently disputed by another study in PLOS , ... Read more »
Lombardi VC, Ruscetti FW, Das Gupta J, Pfost MA, Hagen KS, Peterson DL, Ruscetti SK, Bagni RK, Petrow-Sadowski C, Gold B.... (2009) Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Science (New York, N.Y.), 326(5952), 585-9. PMID: 19815723
Erlwein, O., Kaye, S., McClure, M., Weber, J., Wills, G., Collier, D., Wessely, S., & Cleare, A. (2010) Failure to Detect the Novel Retrovirus XMRV in Chronic Fatigue Syndrome. PLoS ONE, 5(1). DOI: 10.1371/journal.pone.0008519
Personally I like online shopping mainly because it’s easy, fast and convenient, you can shop when you want to anywhere you want to. There’s a gender gap in online shopping. More men than women engage in online shopping and make online purchases while in the offline world women love to shop.
Until recent very few [...]
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Hasan, B. (2010) Exploring gender differences in online shopping attitude. Computers in Human Behavior. DOI: 10.1016/j.chb.2009.12.012
Last week I discussed an interview with F Sommer Anderson and also discussed aspects of central sensitisation syndromes, and Will Baum from where the client is kindly forwarded me a response by Dr Anderson. I am going to muse on one or two aspects of her response because they raise issues that I think are [...]... Read more »
Naik, A., Dyer, C., Kunik, M., & McCullough, L. (2009) Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization. The American Journal of Bioethics, 9(2), 23-30. DOI: 10.1080/15265160802654111
A recently accepted paper shows that working in an oxygen deprived environment can gosh darn it, build muscle when doing resistance work. WHile jokes might start about the variety of ways that one could replicate a near-asphyxiated space - from smoking to putting a plastic bag (with some holes) over one's head - i'm thinking that in the case of resistance training (as opposed to altitude/endurance where there's a definite blood/muscle adaptation), based on the findings, we're maybe seeing predictably heightened threat response brought on by 02 deprivation.... Read more »
Kon, M., Ikeda, T., Homma, T., Akimoto, T., Suzuki, Y., & Kawahara, T. (2009) Effects of Acute Hypoxia on Metabolic and Hormonal Responses to Resistance Exercise. Medicine , 1. DOI: 10.1249/MSS.0b013e3181ce61a5
A FEW years ago, a Boston University team headed by Jim Collins published findings that suggested the means by which bactericidal antibiotics result in cell death, irrespective of the initial cellular target of the drug, was by stimulating the production of hydroxyl radicals, a reactive oxygen species 1. The hydroxyl radical is known to cause [...]... Read more »
Kohanski, M., DePristo, M., & Collins, J. (2010) Sublethal Antibiotic Treatment Leads to Multidrug Resistance via Radical-Induced Mutagenesis. Molecular Cell, 37(3), 311-320. DOI: 10.1016/j.molcel.2010.01.003
Swiss researchers have discovered that bright sunlight exposure can elicit 'photic sneezing" which is characterized by the co-recruitment/hyperactivation of visual and somatosensory cortices. Though the researchers define it as a reflex, it is an anomalous reflex in that it requires activation of cortex unlike the classical knee-jerk reflex and others which only necessitate the activation of spinal cord interneurons ... Read more »
Nicolas Langer*, Gian Beeli, Lutz Jäncke. (2010) When the Sun Prickles Your Nose: An EEG Study Identifying Neural Bases of Photic Sneezing. PLoS ONE, 5(2). info:/10.1371/journal.pone.0009208
The March issue of Experimental Physiology highlights articles relevant to particular sports of the Winter Olympic Games of which I will feature in the upcoming weeks.....let the games begin!!... Read more »
Stuart Egginton and Michael J.White. (2010) 2010 Winter Games Themed Issue. Experimental Physiology, 95(3), 402-403. info:/10.1113/expphysiol.2009.047530
Human papillomavirus (HPV) is a fascinating little bugger. Certain strains can interfere with tumor suppressor genes leading to cancer, especially cervical, anal, and some mouth cancers. Other strains cause genital warts. The vaccine offered in the U.S. (Gardasil) protects against the two strains that cause most cancers and against two strains causing warts. The vaccine has the potential to change the way our population is affected by these diseases.
But we are still learning more about this virus. We know that HPV can be transmitted even without visible lesions. But where are these viruses hiding? A recent study in the Journal of Infectious Disease may have found one reservoir.
Researchers in Slovenia looked at some of the old data on HPV which suggested that pubic hair follicles might contain HPV. To investigate this further, they rounded up 53 Slovenian males with genital warts, and 53 males without warts to serve as controls. They then sampled the warts and plucked hairs from the scrotum, pubic area, and from around the anus. They used PCR to find and identify HPV DNA from the samples. HPV infections and HPV-related cancers are sexually transmitted, and are strongly affected by the immune system, and HPV-related cancers are particularly common in people with HIV, so the study subjects were screened for the presence of HIV and other immune diseases. The researches found significant differences between the two groups studied. Nearly 70% of subjects with warts had HPV isolated from hair samples, compared to about 13% of controls. Strains in the hair matched the strains from the warts present.
Now before you sign up for an expensive and uncomfortable series of sessions with the laser, there are some limitations to this study. The test group were people with warts, meaning they had active HPV disease. This means that while it is plausible that pubic hair serves as a reservoir for HPV, it is not clear if it actually does serve as a reservoir for transmission of the virus---it could be that hair follicles are only infected when there are other active lesions. Also, PCR is remarkably sensitive, so it's possible that the hair samples were contaminated by the warts (although the authors note that "a disposable pair of sterile tweezers and gloves were used for each individual." Comforting, that.).The results from this small study are intriguing, but simply reinforce the need for prevention of transmission via safer sexual practices and immunization. ReferencesPoljak, M., Kocjan, B., Potočnik, M., & Seme, K. (2009). Anogenital Hairs Are an Important Reservoir of Alpha‐Papillomaviruses in Patients with Genital Warts The Journal of Infectious Diseases, 199 (9), 1270-1274 DOI: 10.1086/597619... Read more »
Poljak, M., Kocjan, B., Potočnik, M., & Seme, K. (2009) Anogenital Hairs Are an Important Reservoir of Alpha‐Papillomaviruses in Patients with Genital Warts. The Journal of Infectious Diseases, 199(9), 1270-1274. DOI: 10.1086/597619
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