Patients And Physicians Could Be Alerted To Dangerous Conditions By Implanted Wireless Device

What if a doctor could keep tabs on a patient’s heart failure symptoms on a daily basis, detecting subtle increases in weight and blood pressure, the tell-tale signs of worsening heart fail-ure, and summoning the patient to the hospital before they themselves were aware that any-thing was wrong?

More than half a million Americans are diagnosed with heart failure each year, and the condition causes or contributes to 300,000 deaths annually. In addition to being one of the leading causes of death in the U.S., heart failure is the number one cause of hospitalization for people aged 65 and older, it is the most expensive medical condition in the U.S., and its incidence is growing because of the aging population.

Many heart failure patients receive an implanted cardiac resynchronization therapy defibrillator (CRT-D) device upon diagnosis. Now, wireless technology can monitor these devices, along with blood pressure and weight, on a daily basis. The wireless system offers doctors a significant opportunity to better treat heart failure, keep patients out of the hospital and bring them greater peace of mind.

Using Bluetooth technology, Boston Scientific’s LATITUDE Patient Management System allows doctors to remotely monitor specific information about the patients’ condition to determine if the heart is showing signs of decline. If information is transmitted that suggests something is wrong, the patient’s physician can intervene. LATITUDE is the only FDA-approved product for wireless home monitor-ing of a patient’s heart condition, implanted device, blood pressure and weight. This wireless cardiac rhythm management system is very new, and many consumers don’t realize how important daily monitoring of weight and blood pressure is to detecting early warning signs of worsening heart failure.

Is this something you might be interested in hearing more about? I can arrange interviews for you with cardiologists and patients using this technology in your area. Please call if you have interest or questions. I also have B-Roll that shows the technology if that would assist you in your decision-making process.

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Contact: Bill Gray

Weber Shandwick Worldwide

Calcineurin Inhibitor-Sparing Regimens In Solid Organ Transplantation: Focus On Improving Renal Function And Nephrotoxicity

BERKELEY, CA (UroToday) – Clinical solid organ transplantation is a great success story, and when permanent failure of the kidney, liver, heart, or lung occurs, replacement by transplant is the preferred treatment option. Today with 1-year graft survivals approaching 90% the number of waiting recipients far outstrips organ supply, which has limited further expansion. The improvement in survivals, both for patients and grafts has been an incremental process resulting from advances in surgical and preservation techniques, immunosuppression, better understanding of the rejection process, and advances in diagnosing and treating post transplant infections, among others. One of the major recent advances has been a significant reduction in acute rejection episodes that has coincided with the near universal use of the calcineurin inhibitor drugs, cyclosporine and tacrolimus. However, these reductions have not translated into parallel increases in 5 and 10-year survivals, especially for kidney transplants. Also troubling, is a rising rate of permanent renal failure among non-renal transplant recipients. The toll on the allograft or native kidney appears related to the continuous use of the calcineurin inhibitor drugs, which are nephrotoxic and contribute to chronic renal scarring and loss of function. This phenomenon was also observed 13 months after the first partial face transplant.

During the past few years reducing the use of calcineurin inhibitor drugs has become an intense focus of transplant research. Immunosuppressive protocols have been developed that incorporate either a minimization of the dose of these drugs, complete avoidance of calcineurin inhibitors, or the withdrawal of these agents after 3-6 months of initial use.

An attractive replacement for calcineurin inhibitors has been the mammalian target of rapamycin inhibitor drugs, sirolimus and everolimus, which exhibit little direct nephrotoxicity. Several studies have demonstrated that transplantation with limited use of calcineurin inhibitor drugs results in improved post transplant renal function. Additional follow-up is still needed to confirm that these findings eventuate in better long-term graft survival. No one approach appears to be advantageous for all recipients of solid organs, and using the TOR inhibitors instead of calcineurin inhibitors are accompanied by differing toxicities such as hyperlipidemia, bone marrow suppression, and delayed wound healing. Future trials are needed to help refine precisely which recipients can be safely transplanted without calcineurin inhibitors, and if they are used, when is the best time to withdraw them before permanent renal injury has occurred.

Stuart M. Flechner MD, Jon Kobashigawa MD, Goran Klintmalm MD, PhD, as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc… of their research by referencing the published abstract.

Link to full abstract

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News From The June Issue Of CHEST

PULMONARY HYPERTENSION: A CASE OF MISTAKEN IDENTITY?

New research shows that patients who are diagnosed with pulmonary arterial hypertension (PAH) but fail to respond to targeted therapies may actually have a condition known as pulmonary veno-occlusive disease (PVOD), a subtype of PAH. Australian researchers reviewed 14 cases of clinically diagnosed PAH who had failed medical therapy and found that 12 patients (86 percent) had PVOD and 2 patients (14 percent) had PAH only. Although there were no significant differences in clinical presentations between patients with PVOD and PAH only, there were considerable differences in the vessel pathologic findings and pathophysiology between the two conditions. Researchers speculate that these differences may be the reason why some patients with PAH do not respond to standard PAH therapy. The researchers conclude that further research is needed to determine if PVOD should be considered an individual type of PAH or remain a PAH subtype. The study is published in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

OVERCOMING BARRIERS TO PAIN MANAGEMENT IN THE ICU

A new article underscores the many complexities and challenges associated with managing pain in the critically ill patient. Although the complex conditions presented by the critically ill patient provide significant obstacles, the authors discuss additional barriers to optimal pain management, including outdated clinical practices and faulty systems. The authors also present a number of structured approaches that have been shown to be successful in improving pain treatment in the critically ill patient, as well as future directions for pain management in the ICU. The article is published in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

URINALYSIS MAY REVEAL SEVERITY OF BREATHING DISORDER IN CHILDREN

New research suggests that the urine concentration of lipid mediators may determine the severity of sleep-disordered breathing (SDB) in children. Cysteinyl leukotrienes (CysLTs), lipid mediators associated with inflammatory conditions such as asthma, have been found in high concentrations in the tonsil tissue of children with SDB. Researchers from Greece speculated that high CysLTs concentrations found in urine also could indicate severity of SDB in children. The team measured morning urine concentrations in 19 children with moderate-to-severe SDB, 29 children with mild SDB, 26 children with primary snoring, and 18 control subjects. Results showed that children with moderate-to-severe SDB had higher CysLTs levels than the other groups. Results also showed that urine levels of CysLTs, tonsillar size, and BMI were significant predictors of obstructive apnea-hypopnea index. The report is published in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Source:
Jennifer Stawarz

American College of Chest Physicians

Discovery Of New Bartonella Species That Infects Humans

Researchers at North Carolina State University and the Centers for Disease Control and Prevention have produced the first link between a species of bacteria most commonly found in sheep and human illness.

Dr. Edward Breitschwerdt, professor of internal medicine at NC State’s College of Veterinary Medicine, and NC State colleague Dr. Ricardo Maggi isolated the bacterium Bartonella melophagi from samples of human blood.

B. melophagi is such a newly discovered member of the genus Bartonella it is considered a “Candidatus” species, meaning that its name has yet to be formally accepted. In nature, sheep are the most likely hosts for B. melophagi and transmission among sheep is thought to occur via a wingless fly known as a ked. The route(s) of transmission to humans is unknown.

Their results are published in the January edition of Emerging Infectious Diseases.

The blood samples Breitschwerdt and Maggi tested came from previously healthy women who were suffering from symptoms including muscle fatigue and weakness. One of the patients had been diagnosed with pericarditis, an inflammation of the membrane surrounding the heart. B. melophagi was present in blood samples from both women; Bartonella henselae, a strain of the bacterium which has been associated with human neurological illnesses and fatigue, was isolated from one of the samples.

The research marks the first time that this particular strain of Bartonella has been cultured from human blood and associated with human illness.

“Over the past decade, there has been a rapid expansion in the number of Bartonella species that are documented human pathogens,” Breitschwerdt says. “From this preliminary data, it looks as though we may be able to add another species to that list.”

“A small number of Bartonella in the bloodstream can cause infection, and this fact, coupled with the large variety of transmission routes by which people can become infected, make the diagnosis, treatment and prevention of the illnesses caused by this bacteria a real challenge,” Maggi adds. “I think it’s critical that we discover more about how this bacteria infects people, and how Bartonella infection relates to the subsequent development of progressive illnesses in humans.”

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Source: Tracey Peake

North Carolina State University

Dog Owners More Likely To Share Germs With Pets By Not Washing Hands Than By Sleeping With Dog

Dog owners who sleep with their pet or permit licks on the face are in good company. Surveys show that more than half of owners bond with their pets in these ways.

Research done by a veterinarian at Kansas State University found that these dog owners are no more likely to share the same strains of E. coli bacteria with their pets than are other dog owners.

Dr. Kate Stenske, a clinical assistant professor at K-State’s College of Veterinary Medicine, studied this association as part of her doctoral research at the University of Tennessee. The research is scheduled to appear in an upcoming issue of the American Journal of Veterinary Research.

Stenske said the finding that these human-animal bonding behaviors aren’t more likely to spread germs is good news because there are physical and psychological benefits of pet ownership.

“I became interested in the topic because there is such a strong bond between dogs and their owners,” Stenske said. “If you look at one study, 84 percent of people say their dog is like a child to them.”

Stenske said surveys also show that nearly half of all dog owners share food with their dogs, and more than half allow the dog to sleep in the bed and lick them on the face.

“We also know diseases can be shared between dogs and people,” Stenske said. “About 75 percent of emerging diseases are zoonotic, meaning they are transferrable between humans and other animals. With these two pieces of knowledge, I wanted to examine the public health aspects of such activities.”

Stenske’s study centered on E. coli bacteria, which is common in the gastrointestinal tracts of both dogs and humans.

“People have it, dogs have it, and it normally doesn’t cause any problems,” she said. “But it can acquire genes to make it antibiotic resistant.”

The study examined fecal samples from dogs and their owners and looked at the bacteria’s DNA fingerprints. Stenske found that 10 percent of dog-human pairs shared the same E. coli strains. She also found that the E. coli had more resistance to common antibiotics than expected, although the owners had more multiple-drug resistant strains than their pets.

“This make us think that dogs are not likely to spread multiple drug-resistant E. coli to their owners, but perhaps owners may spread them to their dogs,” Stenske said. “What we learn from this is that antibiotics really do affect the bacteria within our gastrointestinal tract, and we should only take them when we really need to — and always finish the entire prescription as directed.”

The research showed that bonding behaviors like sharing the bed or allowing licks on the face had no association to an increase in shared E. coli. However, Stenske said the research did show an association between antibiotic-resistant E. coli and owners who didn’t wash their hands after petting their dogs or before cooking meals.

“We should use common sense and practice good general hygiene,” she said.

Stenske said future research might focus on the relationship between shared E. coli and the behaviors of cat owners. Not only is cat ownership higher than dog ownership in the United States, but cats also interact with people in different ways than dogs, she said.

“We have a lot to learn,” Stenske said. “In the meantime, we should continue to own and love our pets because they provide a source of companionship. We also need to make sure we are washing our hands often.”

Kansas State University
9 Anderson Hall
Manhattan
KS 66506-0117
United States
k-state.edu

When Dieting To Lose Weight, How Much You Sleep May Be As Important As How Much You Eat

According to a new study being published in Annals of Internal Medicine, the flagship journal of the American College of Physicians, lack of sleep may hinder a dieter’s ability to shed excess body fat.

Ten overweight but otherwise healthy adults on a moderate calorie-restricted diet were randomly assigned to sleep either 5.5 hours or 8.5 hours each night in a closed clinical research environment. After two weeks, researchers measured loss of fat and lean body mass. Compared to participants who slept 5.5 hours a night, the dieters that slept for 8.5 hours lost 56 percent more body fat. The dieters in the sleep restricted group had lost less fat and more lean body mass.

“These results highlight the importance of adequate sleep for maintenance of fat-free body mass when dieting to lose weight,” said Plamen Penev, MD, PhD, Assistant Professor, Section of Endocrinology, at the University of Chicago and lead author of the study.

While measuring fat loss was the primary objective of the study, researchers also assessed other factors including levels of hormones that affect the appetite and weight. In addition, participants in both groups were asked to report how much hunger they experienced during the study.

“Among other hormonal effects, we found that sleep restriction caused an increase in ghrelin levels in the blood,” said Dr. Penev. “Ghrelin is a hormone that has been shown to reduce energy expenditure, stimulate hunger and food intake, promote retention of fat, and increase glucose production in the body. This could explain why sleep-deprived participants also reported feeling hungrier during the study.”

The researchers conclude that even short periods of sleep deprivation can undermine efforts to lose weight. When restricting calories, dieters should consider obtaining adequate amounts of sleep to ensure that they retain lean body mass and lose fat.

Source:

American College of Physicians

Smoking Reduction May Lead To Unexpected Quitting

In a review article in the December Nicotine and Tobacco Research, researchers at the University of Vermont have found an unexpected, effective alternative to motivate smokers to quit smoking – cutting back. According to the qualitative review of 19 studies on smoking reduction in individuals who did not want to quit, this method, typically coupled with the use of nicotine replacement products, led to an increase in quitting in 16 of the studies.

“Cutting back is approved as a method of quitting in several European countries, but not in the United States,” said lead author John Hughes, M.D., a professor of psychiatry at the University of Vermont College of Medicine. “Our review contradicts the commonly held belief that quitting requires stopping abruptly and provides evidence that smokers can quit successfully by reducing the amount of cigarettes smoked. Furthermore, our review indicates cutting back is often a great way to start changing smoking that can lead to eventual quitting.”

Hughes’s report is the largest review of smoking reduction studies published to date. Among the 19 studies reviewed (many of which were randomized, placebo-controlled trials), the two considered the most important involved randomized, controlled trials that assigned smokers to either reduce or not reduce. Both of these studies found that smoking reduction leads to more cessation. Also, in three studies, the effect of reduction was found to be similar to the effect of providing smoking cessation advice. Based on this finding, Hughes suggests that clinicians try recommending reduction for smokers who have not responded to repeated cessation advice.

Hughes and colleague Matthew Carpenter warn that smokers do need to understand that there is no good evidence that cutting back alone decreases smoking-related health risks and thus clinicians should promote reduction only as a step towards eventual cessation to their patients.

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Contact: Jennifer Nachbur

University of Vermont

Agennix Receives Fast Track Designation From FDA For Talactoferrin In Combination With Sunitinib For Renal Cell Carcinoma

Agennix announced that talactoferrin alfa (talactoferrin) has been granted Fast Track designation by the U.S. Food and Drug Administration (FDA) for the first-line treatment of renal cell carcinoma (RCC) in combination with sunitinib (Sutent(R) – Pfizer).

The Fast Track program is designed to expedite the review of investigational drugs for the treatment of patients with serious or life-threatening diseases where there is an unmet medical need. Fast Track designations allow a company to file a New Drug Application (NDA) or Biologics License Application (BLA) on a rolling basis and permit the FDA to review the filing as it is received, rather than waiting for the complete submission prior to commencing the review process. Additionally, NDAs and BLAs for fast track development programs are eligible for priority review which may result in an abbreviated review time of six months.

Additional Clinical Updates

Agennix also announced that two pivotal Phase III trials in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) are underway at a number of leading U.S. clinical sites. FORTIS-M is a randomized, placebo-controlled, 720-patient trial of talactoferrin monotherapy in patients with Stage IIIB/IV NSCLC. Patients who have failed two or more prior systemic anti-cancer therapies will be randomly assigned (2:1) to receive either oral talactoferrin or placebo in additional to standard supportive care. The trial is designed to detect an improvement in overall survival in patients receiving talactoferrin, and results are expected in 2011.

FORTIS-C is a randomized, placebo-controlled trial evaluating 1100 chemo-naive NSCLC patients. Newly diagnosed patients with Stage IIIB/IV NSCLC will be randomly assigned (1:1) to receive standard first-line chemotherapy with carboplatin and paclitaxel plus either oral talactoferrin or placebo. Agennix has received Fast Track designation from the FDA for both NSCLC indications as well as favorable Scientific Advice from the EMEA. Agennix has also received approval of a Special Protocol Assessment from the FDA for the FORTIS-C trial. The designs of these two Phase III trials are based on previous successful randomized, placebo-controlled, Phase II trials which both met their primary endpoint with supporting results on the secondary endpoints.

“We are pleased with the continued development progress with talactoferrin including our most recent Fast Track designation and the initiation of our Phase III NSCLC trials,” said Rick Barsky, Chief Executive Officer, Agennix Incorporated. “This progress, along with the recent success and renewed interest in immunotherapies, will help us reach our goal of making talactoferrin available to patients for the treatment of these devastating diseases.”

About Talactoferrin

Talactoferrin is a novel targeted dendritic cell recruiter and activator (DCRA) being studied for the treatment of several life-threatening diseases including RCC and NSCLC. Talactoferrin mediates its anti-cancer activity by targeting dendritic cells which play an important role in activating innate and adaptive immunity. After being transported into the gut associated lymphoid tissue (GALT), the largest immune organ in the body, orally administered talactoferrin induces the recruitment of immature dendritic cells to the GALT and promotes their maturation. This unique aspect of its function results in recruitment of dendritic cells that have captured tumor antigens while in the peripheral circulation. Following maturation, these dendritic cells activate Natural Killer (NK) and Natural Killer T-cells (NK-T) of the innate immune pathway and CD8+ lymphocytes of the adaptive immune pathway. Initiating the immune response in the GALT, and away from the tumor, reduces the effect of anti-immune factors produced by the tumor.

Talactoferrin Fast Track Designations

Agennix has received Fast Track designation for talactoferrin for the first-line treatment of RCC in combination with sunitinib. Agennix’s RCC submission included the results from a Phase I trial, and a multi-center, single arm Phase II trial of talactoferrin in 44 patients with clear cell RCC who had failed standard therapy. Patients receiving oral talactoferrin in this Phase II trial had a median progression-free survival of 6.4 months, median overall survival of 21.1 months, and a one-year survival rate of 77%. Talactoferrin appeared to be well tolerated, which was consistent with other talactoferrin studies. The results from the Phase II trial were published in Cancer in 2008.

Talactoferrin was previously awarded Fast Track designations in NSCLC both for first line treatment and for patients who have failed two or more prior systemic anti-cancer therapies. These NSCLC Fast Track designations were based upon the clinical activity and tolerability data from two randomized placebo-controlled Phase II trials. Both Phase II trials met their primary endpoint with supporting results on the secondary endpoints.

About Renal Cell Carcinoma (RCC)

RCC is the most common type of kidney cancer, accounting for approximately 90 percent of kidney tumors. According to the American Cancer Society, there are approximately 49,000 new cases of kidney cancer diagnosed each year in the United States. Kidney cancer is uncommon under age 45, and its incidence is highest between the ages of 55 and 84. For non-metastatic RCC, the current standard of care is surgical removal of the kidney (nephrectomy), followed by observation. If the cancer spreads beyond the kidneys, treatment may include chemotherapy, cytokine therapy, targeted therapy, and/or radiation. Currently, sunitinib is the most prescribed targeted therapy for first-line treatment of RCC.

About Agennix

Agennix is a private biopharmaceutical company developing a first-in-class molecule with immunological activity for the treatment of cancer and other unmet medical needs. Agennix’s lead molecule, talactoferrin, is an immunomodulatory protein with a novel mechanism of action. The Company is developing an oral liquid formulation of talactoferrin for cancer indications and a topical gel formulation for the treatment of diabetic foot ulcers. Agennix has more than 90 issued patents and more than 50 pending patents broadly protecting talactoferrin. Agennix has recently initiated Phase III trials in two non-small cell lung cancer indications (talactoferrin monotherapy in patients who have failed two or more previous therapies, and talactoferrin in combination with chemotherapy in previously untreated patients), and is planning a Phase IIb trial in patients with renal cell cancer, and Phase II trials in other cancer indications.

The company has recently agreed to merge its business with GPC Biotech, a publicly traded biopharmaceutical company focused on developing anti-cancer drugs. The merger is subject to the approval of the shareholders’ meeting of GPC Biotech and to further closing conditions, and is expected to be completed by the end of 2009.

Forward Looking Statements

This press release contains forward-looking statements, which express the current beliefs and expectations of the management of Agennix. Such statements are based on current expectations and are subject to risks and uncertainties, many of which are beyond our control, that could cause future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Actual results could differ materially depending on a number of factors, and we caution investors not to place undue reliance on the forward-looking statements contained in this press release. There can be no guarantee that the merger with GPC Biotech will be completed. Forward-looking statements speak only as of the date on which they are made and Agennix undertakes no obligation to update these foward-looking statements even if new information becomes available in the future.

Source: Agennix

Tropical Conflicts Double When El Nino Warmth Hits

In the first study of its kind, researchers have linked a natural global climate cycle to periodic increases in warfare. The arrival of El Nino, which every three to seven years boosts temperatures and cuts rainfall, doubles the risk of civil wars across 90 affected tropical countries, and may help account for a fifth of worldwide conflicts during the past half-century, say the authors. The paper, an interdisciplinary team at Columbia University’s Earth Institute, appears in the current issue of the leading scientific journal Nature.

In recent years, historians and climatologists have built evidence that past societies suffered and fell due in connection with heat or droughts that damaged agriculture and shook governments. This is the first study to make the case for such destabilization in the present day, using statistics to link global weather observations and well-documented outbreaks of violence. The study does not blame specific wars on El NiГ±o, nor does it directly address the issue of long-term climate change. However, it raises potent questions, as many scientists think natural weather cycles will become more extreme with warming climate, and some suggest ongoing chaos in places like Somalia are already being stoked by warming climate.

“The most important thing is that this looks at modern times, and it’s done on a global scale,” said Solomon M. Hsiang, the study’s lead author, a graduate of the Earth Institute’s Ph.D. in sustainable development. “We can speculate that a long-ago Egyptian dynasty was overthrown during a drought. That’s a specific time and place, that may be very different from today, so people might say, ‘OK, we’re immune to that now.’ This study shows a systematic pattern of global climate affecting conflict, and shows it right now.”

The cycle known as the El NiГ±o-Southern Oscillation, or ENSO, is a periodic warming and cooling of the tropical Pacific Ocean. This affects weather patterns across much of Africa, the Mideast, India, southeast Asia, Australia, and the Americas, where half the world’s people live. During the cool, or La NiГ±a, phase, rain may be relatively plentiful in tropical areas; during the warmer El NiГ±o, land temperatures rise, and rainfall declines in most affected places. Interacting with other factors including wind and temperature cycles over the other oceans, El NiГ±o can vary dramatically in power and length. At its most intense, it brings scorching heat and multi-year droughts. (In higher latitudes, effects weaken, disappear or reverse; La NiГ±a conditions earlier this year helped dry the U.S. Southwest and parts of east Africa.)

The scientists tracked ENSO from 1950 to 2004 and correlated it with onsets of civil conflicts that killed more than 25 people in a given year. The data included 175 countries and 234 conflicts, over half of which each caused more than 1,000 battle-related deaths. For nations whose weather is controlled by ENSO, they found that during La NiГ±a, the chance of civil war breaking out was about 3 percent; during El NiГ±o, the chance doubled, to 6 percent. Countries not affected by the cycle remained at 2 percent no matter what. Overall, the team calculated that El NiГ±o may have played a role in 21 percent of civil wars worldwide – and nearly 30 percent in those countries affected by El NiГ±o.

Coauthor Mark Cane, a climate scientist at Columbia’s Lamont-Doherty Earth Observatory, said that the study does not show that weather alone starts wars. “No one should take this to say that climate is our fate. Rather, this is compelling evidence that it has a measurable influence on how much people fight overall,” he said. “It is not the only factor – you have to consider politics, economics, all kinds of other things.” Cane, a climate modeler, was among the first to elucidate the mechanisms of El NiГ±o, showing in the 1980s that its larger swings can be predicted – knowledge now used by organizations around the world to plan agriculture and relief services.

The authors say they do not know exactly why climate feeds conflict. “But if you have social inequality, people are poor, and there are underlying tensions, it seems possible that climate can deliver the knockout punch,” said Hsiang. When crops fail, people may take up a gun simply to make a living, he said. Kyle C. Meng, a sustainable-development Ph.D. candidate and the study’s other author, pointed out that social scientists have shown that individuals often become more aggressive when temperatures rise, but he said that whether that applies to whole societies is only speculative.

Bad weather does appear to tip poorer countries into chaos more easily; rich Australia, for instance, is controlled by ENSO, but has never seen a civil war. On the other side, Hsiang said at least two countries “jump out of the data.” In 1982, a powerful El NiГ±o struck impoverished highland Peru, destroying crops; that year, simmering guerrilla attacks by the revolutionary Shining Path movement turned into a full-scale 20-year civil war that still sputters today. Separately, forces in southern Sudan were already facing off with the domineering north, when intense warfare broke out in the El NiГ±o year of 1963. The insurrection abated, but flared again in 1976, another El NiГ±o year. Then, 1983 saw a major El NiГ±o–and the cataclysmic outbreak of more than 20 years of fighting that killed 2 million people, arguably the world’s bloodiest conflict since World War II. It culminated only this summer, when South Sudan became a separate nation; fighting continues in border areas. Hsiang said some other countries where festering conflicts have tended to blow up during El NiГ±os include El Salvador, the Philippines and Uganda (1972); Angola, Haiti and Myanmar (1991); and Congo, Eritrea, Indonesia and Rwanda (1997).

The idea that environment fuels violence has gained currency in the past decade, with popular books by authors like Jared Diamond, Brian Fagan and Mike Davis. Academic studies have drawn links between droughts and social collapses, including the end of the Persian Gulf’s Akkadian empire (the world’s first superpower), 6,000 years ago; the AD 800-900 fall of Mexico’s Maya civilization; centuries-long cycles of warfare within Chinese dynasties; and recent insurgencies in sub-Saharan Africa. Last year, tree-ring specialists at Lamont-Doherty Earth Observatory published a 1,000-year atlas of El NiГ±o-related droughts; data from this pinpoints droughts coinciding with the downfall of the Angkor civilization of Cambodia around AD 1400, and the later dissolution of kingdoms in China, Vietnam, Myanmar and Thailand.

Some scientists and historians remain unconvinced of connections between climate and violence. “The study fails to improve on our understanding of the causes of armed conflicts, as it makes no attempt to explain the reported association between ENSO cycles and conflict risk,” said Halvard Buhaug, a political scientist with the Peace Research Institute Oslo in Norway who studies the issue. “Correlation without explanation can only lead to speculation.” Another expert, economist Marshall Burke of the University of California, Berkeley, said the authors gave “very convincing evidence” of a connection. But, he said, the question of how overall climate change might play out remains. “People may respond differently to short-run shocks than they do to longer-run changes in average temperature and precipitation,” he said. He called the study “a useful and illuminating basis for future work.”

Up To 10 Percent Of Strokes Occur In Children And Young Adults

The news that Vice President Joe Biden’s 41-year-old son has suffered a stroke is highlighting the problem of strokes in young people.

“Strokes can occur at any age,” said Dr. JosГ© Biller of Loyola University Health System, author of the landmark textbook, “Stroke in Children and Young Adults.”

Children and adults younger than 45 years account for 5 percent to 10 percent of all stroke cases, Biller said.

“The impact of strokes can be devastating to young adults, their families and society,” Biller said.

The quicker a patient is diagnosed and treated, the better the outcome. “But people don’t think that children and young adults can get strokes,” Biller said. “So family members often are slow to recognize strokes.”

The incidence of stroke increases dramatically with advancing age. The incidence of stroke doubles each decade past 55 years of age. Half of all strokes occur in people older than 70 to 75 years, Biller said.

However, children and adults younger than 45 account for as many as 10 percent of all stroke cases. In developing countries, the proportion is even higher, with 20 percent to 30 percent of strokes occurring in people younger than 45.

There are notable differences in incidence, presentation, risk factors, and prognosis in stroke occurring in individuals younger than 45, compared with individuals older than 45. There are multiple causes of ischemic stroke, especially in young adults. Risk factors are extensive and diverse in this population.

A large proportion of strokes are preventable by controlling blood pressure, treating atrial fibrillation (irregular heart rhythm) and stopping cigarette smoking.

Warning signs of stroke include sudden:

Weakness of the face, arm or leg, especially on one side of the body.

Numbness or tingling of the face or one side of the body.

Confusion or trouble understanding.

Trouble speaking.

Trouble seeing in one or both eyes.

Trouble walking; dizziness; loss of balance or coordination.

Severe, unusual headaches.

If you experience stroke symptoms, call 911 immediately.

“Every second counts,” Biller said. “Time is brain.”

Source
Loyola University Health System