July

With nearly four in five older Americans living with multiple chronic medical conditions, a new study by researchers at Johns Hopkins Bloomberg School of Public Health finds that the more ailments you have after retirement age, the shorter your life expectancy. The analysis, one of the first to examine the burden of multiple chronic conditions on life expectancy among the elderly, may help explain why increases in life expectancy among older Americans are slowing.

A report on the findings, based on an analysis of 1.4 million Medicare enrollees, appears in the August issue of the journal Medical Care.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” says Eva H. DuGoff, a recent PhD recipient at the Johns Hopkins Bloomberg School of Public Health and lead author of the report. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

For their analysis, researchers used the Medicare 5% sample, a nationally representative sample of Medicare beneficiaries, enrolled as of January 1, 2008, which included 21 defined chronic conditions and the records of nearly 1.4 million people 67 and older.

Life expectancy in the U.S. is rising more slowly than in other parts of the developed world and many blame the obesity epidemic and its related health conditions for the worsening health of the American population.

The analysis found that, on average, a 75-year-old American woman with no chronic conditions will live 17.3 additional years (that’s to more than 92 years old). But a 75-year-old woman with five chronic conditions will only live, on average, to the age of 87, and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men, while white people live longer than black people.

It’s not just how many diseases you have, but also what disease that matters. At 67, an individual with heart disease is estimated to live an additional 21.2 years on average, while someone diagnosed with Alzheimer’s disease is only expected to live 12 additional years.

On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up.

“We tend to think about diseases in isolation. You have diabetes or you have heart failure. But many people have both, and then some,” says senior author Gerard F. Anderson, PhD, a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications. Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts.”

The researchers say their findings could be useful to Social Security and Medicare planners as they make population and cost predictions for the future. Policymakers are facing a different landscape as so many more people are living with multiple chronic conditions than before: 60 percent of those 67 and older in the U.S. have three or more of these diseases, the researchers found. Eventually, there may be a tipping point, when the medical advances that have boosted life expectancy for so long can no longer keep pace with the many illnesses people are collecting as they age.

“We already knew that living with multiple chronic conditions affects an individual’s quality of life, now we know the impact on quantity of life,” DuGoff says. “The growing burden of chronic disease could erase decades of progress. We don’t want to turn around and see that life expectancy gains have stopped or reversed.”

“Multiple Chronic Conditions and Life Expectancy, A Life Table Analysis” was written by Eva H. DuGoff, PhD; Vladimir Canudas-Romo, PhD; Christine Buttorff; Bruce Leff, MD; and Gerard F. Anderson, PhD. The study was supported by the American Insurance Group.

Source: Johns Hopkins

Men who have a vasectomy may be at increased risk for aggressive prostate cancer, a new study suggests.

But the risk is comparatively small, the researchers acknowledged. And several urologists not involved with the study said more research is needed to determine if the study findings are truly accurate.

For the study, Harvard researchers analyzed data from more than 49,400 American men who were followed for 24 years, starting in 1986. During that time, 6,023 cases of prostate cancer were diagnosed among the men, including 811 fatal cases.

The 25 percent of the men in the study who’d had a vasectomy had a 10 percent increased risk of developing prostate cancer, according to the study published online July 7 in the Journal of Clinical Oncology.

Vasectomy was not linked with an increased risk of low-grade prostate cancer. But it was associated with a 20 percent higher risk of advanced prostate cancer and a 19 percent greater risk of fatal prostate cancer, respectively, the study authors said.

Even among men who had regular prostate-specific antigen (PSA) screening tests for prostate cancer, those who had a vasectomy were 56 percent more likely to develop fatal prostate cancer. This link was strongest among men who had a vasectomy at a younger age.

However, the absolute risk of developing deadly prostate cancer was small, the study authors noted — 16 of every 1,000 men.

“This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19 additional years of follow-up and tenfold greater number of cases. The results support the hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate cancer,” study co-author Lorelei Mucci, associate professor of epidemiology at the Harvard School of Public Health, said in a university news release.

About 15 percent of men in the United States have a vasectomy. Prostate cancer is the second leading cause of death among American men, although most men diagnosed with the disease don’t die from it.

“The decision to opt for a vasectomy as a form of birth control is a highly personal one and a man should discuss the risks and benefits with his physician,” study co-author Kathryn Wilson, a research associate in the department of epidemiology, said in the university news release.

Dr. Louis Kavoussi is chairman of urology at North Shore-LIJ Health System in New Hyde Park, N.Y. He said: “I would be cautious about applying these findings to clinical practice right now. This is not like cigarette smoking causing a large number of people to develop lung cancer. This is a small increase in the risk of prostate cancer. I think further studies really need to be mandated in a better controlled fashion.

“There are a whole host of potential unknown reasons why this potentially could be real,” he added. “On the other hand, this is a retrospective study — a backwards-looking study over many, many years, and the increased risk is small. So can this be an error in statistics? There are many papers over the years that don’t show a correlation with this.”

Dr. Aaron Katz, chairman of urology at Winthrop-University Hospital in Mineola, N.Y., suggested that men who’ve undergone a vasectomy may simply have their cancers caught more often because they see their doctor more often.

“Several studies have looked at the association between vasectomy and prostate cancer. It is well known that men who have had a vasectomy are more likely to be seen more frequently by urologists in follow-up than men who never had a vasectomy, and will undergo more frequent PSA testing,” he said.

The Harvard researchers said they were able to compensate for factors such as more frequent visits to doctors before reaching their conclusions.

Kavoussi added: “The implications of this study, if it becomes dogma, can be quite profound in society. All of a sudden birth control has been pushed entirely onto women. There are potential side effect issues with birth control for women as well.”

Support for the study was provided by grants from the U.S. National Cancer Institute, among other sources.

Source: CBS News

As temperatures increased above 50°F (10°C) in several large U.S. cities, risk of kidney stones also increased significantly researchers said.

A study of 60,433 privately insured patients across five cities — Atlanta, Chicago, Dallas, Los Angeles, and Philadelphia — found that the maximum risk for kidney stone presentation occurred within 3 days of a high daily temperature and was likely mediated by an effect on patients’ hydration.

The risk was statistically significant in all cities except Los Angeles, according to the paper, published online in Environmental Health Perspectives.

Cumulative relative risks for a mean daily temperature of 86°F (30°C) versus 50°F were:

• Atlanta (1.38, 95% CI 1.07-1.79)
• Chicago (1.37, 95% CI 1.07-1.76)
• Dallas (1.36, 95% CI 1.10-1.69)
• Los Angeles (1.11, 95% CI 0.73-1.68)
• Philadelphia (1.47, 95% CI 1.00-2.17)

The five cities represent climates in which 30% of the world’s population lives, according to study author Gregory Tasian, MD, MSc, at the University of Pennsylvania, and colleagues.

Using a time series design and distributed lag nonlinear model, researchers collected private health insurance claims data from 2005-2011 as well as weather data for the selected cities. Tasian and colleagues examined presentation for kidney stones within a 20-day window of temperature exposure.

Cases tended to occur within a few days after episodes of extreme temperature, with a first peak at about 2 to 3 days and a second at 4 to 6 days.

“We were expecting to find a short lag time between heat and presentation, so it wasn’t really surprising that the lag time was detected within a week,” Tasian told MedPage Today.

Tasian and colleagues hypothesized that dehydration is the causal mechanism between the effect of heat and stone presentation. When patients who are already at risk get dehydrated, calcium and uric acid become more supersaturated, and calcium stones begin to form, they said.

“It’s all linked to fluid. Saying heat leads to fluid loss would be the direct link,” said Allan Jhagroo, MD, a professor of nephrology at the University of Wisconsin who was not associated with the study.

The researchers also hypothesized that the hotter weather may have led to stone formation in patients exposed to hotter weather who would have normally developed stones at a future time.

Colder weather was associated with a relative risk in Atlanta, Chicago, and Philadelphia, perhaps because patients stay indoors where it can be hotter. It’s also conceivable that hydration may suffer during extremes of cold (when indoor humidity, which was not measured in the study, is usually low) as well as hot weather.

Outdoor humidity was measured, but was not found to be a predictor for kidney stones.

The researchers also suggested that the number of hot days in a year is probably a better indicator of kidney stone risk than mean annual temperature. Atlanta, for example, had almost twice the rate of kidney stones compared with Los Angeles but had a similar mean temperature. It had, though, on average 53 days a year in which the daily mean temperature was higher than 80°F. Los Angeles had only 10.

Dallas had 324 days hotter than 86°F during the period, 20 times more than such days in Atlanta, the next closest city. But it had the same risk increase. Tasian and colleagues suggested that the population of Dallas may have adapted to the local climate, spending more time indoors and drinking more fluids. They also noted that their data were sparse for extreme weather, and their statistical methods may have flattened the associations somewhat.

A previous study reported by MedPage Today found that, as temperatures across the U.S. increase because of climate change, the prevalence of kidney stones may be expected to grow. Tasian said that more research needs to be done to see how the risk of kidney stones may change with temperature increases.

The authors acknowledged several limitations to the study. They had no data on individuals’ actual exposure to outdoor temperatures, which would vary. All the patients had commercial insurance and may spend more time indoors, with air conditioning, than those with public or no insurance. It is also possible that temperature differentially affects subgroups such as older versus younger patients.

Additionally, the research was concerned only with presentation at the hospital and not stone formation.

Jhagroo suggested that this left open the question of whether “warmer weather leads to passage, or warmer weather leads to both formation and passage.”

Source: Med Page Today

Sleep disturbances such as apnea may increase the risk of Alzheimer’s disease, while moderate exercise in middle age and mentally stimulating games, such as crossword puzzles, may prevent the onset of the dementia-causing disease, according to research to be presented Monday.

The findings — which are to be introduced during the six-day Alzheimer’s Association International Conference in Copenhagen — bolster previous studies that suggest sleep plays a critical role in the aging brain’s health, perhaps by allowing the body to cleanse itself of Alzheimer’s-related compounds during downtime. The studies also add to a growing body of literature that suggests keeping the brain busy keeps it healthy.

The battle against Alzheimer’s disease has become more urgent for the United States and other developing nations as their populations turn increasingly gray. The disease is the leading cause of dementia in older people and afflicts more than 5 million Americans. At its current pace, the number is expected to soar to 16 million people by 2050.

In 2012, the United States adopted a national plan to combat the disease and the Group of Eight nations last year adopted a goal of providing better treatment and prevention by 2025.

Erin Heintz, a spokeswoman for the Alzheimer’s Association, said U.S. government funding to combat the disease now stands at about $500 million a year. To reach its 2025 goal, th e United States should be spending $2 billion a year, she said.

The sleep study, conducted by University of California at San Francisco researchers on a large sample of veterans, found that those with diagnosed sleep disorders such as apnea or insomnia were 30 percent more likely to suffer dementia than veterans without such problems. Veterans who suffered from sleep problems and post-traumatic stress disorder (PTSD) had an 80 percent greater risk.

“I would say that this is another important study showing this link between sleep and subsequent diagnosis of dementia,” Kristine Yaffe, a psychiatry professor at UCSF who heads its Dementia Epidemiology Research Group, said in a telephone interview. She said her study’s findings benefited from having such a large sample of participants: Researchers used eight years of records on 200,000 veterans, most of whom were male and 55 or older.

It is well known that people afflicted with Alzheimer’s suffer from sleep disorders, Yaffe said, but further research is necessary to determine whether sleep disturbance heightens the risk of getting dementia or is a symptom.

In a separate study, researchers at the Wisconsin Alzheimer’s Institute and the Wisconsin Alzheimer’s Disease Research Center wanted to find out whether middle-aged people who engage in mentally stimulating activities might reduce their risk of cognitive impairment and dementia. Forty percent of the subject group carried the gene linked to Alzheimer’s and 74 percent had a parent with the illness, two factors known to increase the risk of getting the disease.

The researchers studied 329 participants — 69 percent of whom were women, whose mean age was about 60 — to find out how often the participants read books, visited museums, played games such as checkers or worked on puzzles.

The subjects also underwent a battery of tests, including MRI brain scans to measure the volume of those regions commonly afflicted by Alzheimer’s.

For purposes of the study, researchers focused on the group’s game-playing habits to see if the frequency of playing games was related to better brain and cognitive health.

Stephanie Schultz, lead author of the study, said that although more research is necessary to know for sure, the findings suggest that stimulating the brain with ordinary diversions such as crossword puzzles may help some people preserve brain tissue and cognitive functions that are vulnerable to dementia. Those who reported a higher frequency of playing games also had greater brain volume in regions affected by Alzheimer’s, such as the hippocampus.

“The more they play these types of games, the better it is for … brain health,” she said.

One reason could be that game-playing involves more complicated processes across multiple regions of the brain, compared with more passive forms of mental engagement, the researchers said.

“It’s very clear it’s a different quality of mental engagement when you’re playing games of skill than when you’re reading a book,” said Ozioma Okonkwo, an assistant professor of medicine at the University of Wisconsin School of Medicine and senior author of the study. “To win a card game, you have to judge, you have to plan, you have to do something, you have to remember what the last player played.”

Okonkwo said the results were exciting particularly because they held true for people with a family history of Alzheimer’s and a genetic disposition to the disease.

“These individuals already have two strikes against them,” he said.

Similarly, a three-year study of people with mild cognitive impairment by researchers at the Mayo Clinic Study of Aging suggests that moderate physical exercise in middle age could decrease the risk that their cognitive deficits progress to dementia. The study looked at the timing of regular exercise — undertaken either in midlife between the ages of 50 and 65, or later in life, from age 70 and up — and its relationship to the onset of dementia in a group of 280 elderly people. Their median age was 81.

Oddly, however, the association did not hold for people who engaged in light or vigorous exercise in middle age or for any level of physical activity later in life.

On a similarly counterintuitive note, another study suggested that high blood pressure among people at least 90 years old — “the oldest old” — may protect against cognitive impairment. Researchers at the University of California at Irvine said that although hypertension is believed to increase the risk of Alzheimer’s and dementia for middle-aged people, the risk may shift with time.

Their study, which examined 625 people who are 90 or older, found that people who were diagnosed with high blood pressure between the ages of 80 and 89 had a significantly lower risk of dementia. People with hypertension after the age of 90 had an even lower risk, the researchers said.

(Source: Washington Post)

Sedentary lifestyle and not caloric intake may be to blame for increased obesity in the US, according to a new analysis of data from the National Health and Nutrition Examination Survey (NHANES). A study published in the American Journal of Medicine reveals that in the past 20 years there has been a sharp decrease in physical exercise and an increase in average body mass index (BMI), while caloric intake has remained steady. Investigators theorized that a nationwide drop in leisure-time physical activity, especially among young women, may be responsible for the upward trend in obesity rates.

By analyzing NHANES data from the last 20 years, researchers from Stanford University discovered that the number of US adult women who reported no physical activity jumped from 19.1% in 1994 to 51.7% in 2010. For men, the number increased from 11.4% in 1994 to 43.5% in 2010. During the period, average BMI has increased across the board, with the most dramatic rise found among young women ages 18-39.

“These changes have occurred in the context of substantial increases in the proportion of adults reporting no leisure-time physical activity, but in the absence of any significant population-level changes in average daily caloric intake,” explains lead investigator Uri Ladabaum, MD, MS, Associate Professor of Medicine (Gastroenterology and Hepatology), Stanford University School of Medicine. “At the population level, we found a significant association between the level of leisure-time physical activity, but not daily caloric intake, and the increases in both BMI and waist circumference.”

The study looked at the escalation of obesity in terms of both exercise and caloric intake. While investigators did not examine what types of foods were consumed, they did observe that total daily calorie, fat, carbohydrate, and protein consumption have not changed significantly over the last 20 years, yet the obesity rate among Americans is continuing to rise.

Researchers also tracked the rise in abdominal obesity, which is an independent indicator of mortality even among people with normal BMIs. Abdominal obesity is defined by waist circumference of 88 cm (34.65 in) or greater for women and 102 cm (40.16 in) or greater for men. Data showed that average waist circumference increased by 0.37% per year for women and 0.27% per year for men. Just like the rise in average BMIs, the group most affected by increased rates of abdominal obesity was women.

“The prevalence of abdominal obesity has increased among normal-weight women and overweight women and men,” observes Dr. Ladabaum. “It remains controversial whether overweight alone increases mortality risk, but the trends in abdominal obesity among the overweight are concerning in light of the risks associated with increased waist circumference independent of BMI.”

When Ladabaum et al grouped respondents to the most recent NHANES survey by race/ethnicity and age, they found that more than 50% of the workforce-aged adults in eight demographic subgroups reported no leisure-time physical activity. The following chart displays the results and highlights the differences between the 1994 survey results and those collected in 2010 (albeit, with slightly different survey methods). According to this data, women, and black and Mexican-American women in particular, showed the greatest decreases in reported exercise.

While increased caloric intake is often blamed for rising rates of obesity, no association between these was found in this study; in contrast, an association was found between the trends over time for lack of physical activity and high BMI numbers. “Our findings do not support the popular notion that the increase of obesity in the United States can be attributed primarily to sustained increase over time in the average daily caloric intake of Americans,” concludes Dr. Ladabaum. “Although the overall trends in obesity in the United States are well appreciated and obesity prevalence may be stabilizing, our analyses highlight troublesome trends in younger adults, in women, and in abdominal obesity prevalence, as well as persistent racial/ethnic disparities.”

There is no easy answer in our ongoing battle against obesity, but identifying the link between the drop in physical activity and increased BMIs, as well as the groups particularly affected, can assist public health officials to develop targeted, effective interventions. In an accompanying commentary Pamela Powers Hannley, MPH, Managing Editor, the American Journal of Medicine, notes, “If we as a country truly want to take control of our health and our health care costs, the Ladabaum et al paper should be our clarion call. From encouraging communities to provide safe places for physical activity to ensuring ample supply of healthy food to empowering Americans to take control of their health, we must launch a concerted comprehensive effort to control obesity.”

A government scientist cleaning out a storage room last week at a lab on the National Institutes of Health’s Bethesda campus found decades-old vials of smallpox, the second incident involving the mishandling of a highly dangerous pathogen by a federal health agency in a month.

The vials, which appear to date from the 1950s, were flown Monday by government plane to the Centers for Disease Control and Prevention headquarters in Atlanta, officials said Tuesday. Initial testing confirmed the presence of ­smallpox-virus DNA. Further testing, which could take up to two weeks, will determine whether the material is live. The samples will be destroyed after the testing is completed.

There is no evidence that any of the vials had been breached or that workers in the lab, which has been used by the Food and Drug Administration for decades, were exposed to infection. FDA employees did not receive an official communication about the discovery until Tuesday evening. One scientist, who works in the building and spoke on the condition of anonymity for fear of retaliation, said he learned about it Tuesday when his supervisor read a media report.

The FBI and the CDC’s division of select agents and toxins are investigating.

“Due to the potential bio-safety and bio-security issues involved, the FBI worked with CDC and NIH to ensure safe packaging and secure transport of the materials,” FBI spokesman Christopher M. Allen said in an e-mail to The Washington Post.

 

Experts explain the biosafety precautions and procedures at the National Emerging Infectious Diseases Laboratories. (Boston University)

This is the first time the deadly virus has been discovered outside the only two facilities in the world where smallpox samples are allowed, by international agreement, to be stored — a highly secure lab at the CDC headquarters in Atlanta and a virology and biotechnology research center in Novosibirsk, Russia.

Smallpox — which vanished from the United States just after World War II and was eradicated globally — killed hundreds of millions of people in the 20th century alone.

“It was considered one of the worst things that could happen to a community to have a smallpox outbreak,” said Michael Osterholm, a expert on bioterrorism and director of the Center for Infectious Diseases Research and Policy at the University of Minnesota. “It’s a disease that’s had a major impact on human history.”

There is no cure for smallpox, and historically about one-third of people who contract it die from the disease. Though not as readily contagious as some other diseases, such as influenza, smallpox promises plenty of misery once contracted. Symptoms include high fever, fatigue and fluid-filled lesions that often ooze and crust over, leaving survivors irreversibly scarred.

Last month, a safety lapse involving three CDC labs in Atlanta led to the accidental release of live anthrax bacteria. The incident resulted in as many as 84 employees having to get a vaccine or take antibiotics as a precaution and the reassignment of a lab director. Scientists failed to take proper precautions to inactivate bacteria samples before transferring them to other labs not equipped to handle live anthrax.

It is not entirely clear how the smallpox samples ended up in Building 29A on the NIH campus in Maryland. The building is an FDA lab, one of several the agency has operated on the NIH campus since 1972. The vials were discovered while employees were preparing for the lab’s move to the FDA’s main campus in White Oak, Md.

An FDA scientist on July 1 found several cardboard boxes containing dozens of glass vials, each several inches long and sealed with melted glass, according to CDC spokesman Tom Skinner. The boxes were in a storage room kept at about 40 degrees. Several vials were labeled as flu virus, mumps or typhus, he said. Sixteen vials were labeled “variola,” or smallpox, or were suspected of containing smallpox virus. Those vials were in a box with cotton padding. All the vials were immediately secured in a containment laboratory on the NIH campus. The 16 suspect vials were flown to Atlanta. Testing confirmed the presence of smallpox virus DNA in six.

“This was a lab that didn’t realize it had these vials,” Skinner said. Because the vials are made of glass and were sealed with melted glass, officials say the vials appear to date to the 1950s. He said the material could have been sitting around in the storage room “unbeknownst to the people up there for many years.”

In an e-mail late Tuesday, an FDA spokeswoman said the laboratories where the smallpox was discovered are used for biologics research, including research on vaccines. The agency noted that the regulation of vaccines, including the smallpox vaccine, was under the authority of NIH until July 1972, when it transferred to the FDA.

“Although an investigation is ongoing, it is likely that an investigator involved in smallpox research, prior to the time that smallpox was eliminated, may have left the boxes in a cold storage area,” FDA spokeswoman Jennifer Rodriguez said in the e-mail. “These were then only discovered as part of the inventory undertaken in preparation for the move of the FDA laboratories from the NIH campus in Bethesda to the consolidated FDA campus in Silver Spring.”

Rodriguez said the agency has completed an inventory of all common storage areas in its NIH campus buildings and found no other materials of public health concern.

“We are carefully examining our policies and procedures regarding the security of our laboratories and storage of biologic specimens,” she said. “We will ensure the implementation of a corrective action plan to ensure that our biological specimens are inventoried and properly secured.”

About 18,000 people work on the sprawling NIH campus in Bethesda. An NIH spokeswoman said the agency is planning a comprehensive search of all laboratory spaces. Officials did not notify employees about the discovery, she said, because the vials were checked and found to have no breaches. FDA laboratory staffers uninvolved in the discovery were notified by e-mail Tuesday evening, after the vials had been transferred to the CDC and confirmed to contain smallpox, Rodriguez said.

The CDC notified the World Health Organization. A spokeswoman for the WHO said any samples of the smallpox virus found outside the two facilities where it is allowed must be moved to those locations or destroyed.
Osterholm, the expert on bio­terrorism, likened the discovery to finding a long-forgotten trunk in an attic and said that biologists are no different from other people, collecting things and storing them. He said government officials handled the discovery appropriately and acted quickly and cautiously. “I’m not convinced this will be the last of these potential situations,” he said. “I wouldn’t be surprised if somewhere else in the world this same type of thing happens again.”

An accidental release of the virus potentially could sicken a small number of people who come into contact with it, though Osterholm said such an outbreak probably could be contained rapidly given today’s vaccine supplies and antiviral drugs. The more worrisome prospect, he said, would be if someone with bad intentions were able to aerosolize the virus and spread it over a large metropolitan area. “That could be a global crisis,” he said.

When smallpox was officially declared eradicated in late 1979, an agreement was reached under which any remaining stocks of the virus would be destroyed or sent to one of two secure laboratories — the CDC in Atlanta or the State Research Center of Virology and Biotechnology in Russia.

In the decades since, the scientific community has wrestled over whether to destroy the remaining stockpiles of the smallpox virus or hang on to them in case they are needed for research.

Those who argue in favor of destroying the remaining smallpox samples — a group that includes D.A. Henderson, who led a worldwide effort to eradicate the disease decades ago — point out that an effective vaccine exists and that maintaining live samples risks accidental infections or, worse, vials falling into the hands of terrorists. Other scientists, including officials at the CDC and NIH, have insisted that there is more valuable research to be done before scientists can say confidently that adequate protections exist against any future smallpox threats.

This spring at a meeting in Geneva, the World Health Assembly, the WHO’s decision-making body, revisited the question over whether to destroy the remaining stockpiles of smallpox. Amid sharply divided opinions on the issue, the group postponed a final decision.

Source: Washington Post

Smartphones reflect the personal microbial world of their owners, say US scientists.

More than 80% of the common bacteria that make up our personal bacterial “fingerprints” end up on their screens, a study suggests.

Personal possessions, such as phones, might be useful for tracking the spread of bacteria, they report in PeerJ.

They reflect our microbiome – the trillions of different micro-organisms that live in and on our bodies.

Mobile phone users have been found to touch their devices on average 150 times a day.

Scientists have found an overlap between the collection of micro-organisms naturally present on our bodies and those on the screens of smartphones.

They say this could one day be used to track people’s exposure to bacteria.

In the study, biologists from the University of Oregon sequenced the DNA of microbes found on the index fingers and thumbs of 17 people.

They also took swabs of the subjects’ smartphones.

A total of 7,000 different types of bacteria were found in 51 samples.

On average, 22% of bacterial families overlapped on fingers and phones.

Some 82% of the most common bacteria present on participants’ fingers were also found on their phones.

They included three families that are commonly found on the skin or in the mouth – Streptococcus, Staphylococcus and Corynebacterium.

Men and women both shared bacteria with their phones, but the connection was stronger in women.

Lead researcher Dr James Meadow said while the sample size was small, the findings were “revealing”.

“This project was a proof-of-concept to see if our favourite and most closely held possessions microbially resemble us,” he said.

“We are ultimately interested in the possibility of using personal effects as a non-invasive way to monitor our health and our contact with the surrounding environment.”

The researchers say there is no evidence that mobile phones present any more infection risk than any other possession.

But they say our phones might one day be used to study whether people have been exposed to certain bacteria, particularly healthcare workers.

The study confirms that “we share more than an emotional connection with our phones – they carry our personal microbiome”, Dr Meadow added.

There is increasing scientific interest in the human microbiome – the population of trillions of micro-organisms that live in our gut, mouth, skin and elsewhere on our bodies.

Bacteria can be harmful but they can also have beneficial effects, particularly in the gut, by digesting food and making essential nutrients and vitamins.

Getting more protein in your diet, though not red meat, may reduce your risk for stroke, a review of studies found.

Scientists reviewed seven prospective studies involving more than 250,000 people and found that after adjusting for various stroke risks and for other nutrients consumed, those who had the highest consumption of protein had a 20 percent decreased risk for stroke compared with those with the lowest.

Each increase of 20 grams per day in protein — about the amount in a 3-ounce serving of chicken or fish or a cup of beans — was associated with a 26 percent decrease in risk, a dose-response relationship that further strengthens the association.

The finding does not apply to red meat, which has been shown to increase the risk for stroke and was not evaluated in the studies reviewed.

Some evidence suggested that animal protein was slightly more effective than vegetable protein, although there was not enough data on vegetable consumption to reach a definitive conclusion about the exact difference.

“Moderate dietary protein intake may lower the risk of stroke,” said the senior author, Dr. Xinfeng Liu, a neurologist at the Nanjing University School of Medicine in China. “This does not mean that people should avoid red meat entirely,” he added, but “increasing intake of fish or vegetables is recommended.”