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August 10, 2012
NIH Podcast Episode #0165
Balintfy: Welcome to episode 165 of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health – NIH . . . Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this episode, news on the future of joint replacements, for back-to-school time, a study about college communities, and…
“Healthy eating and regular physical activity may help the whole family meet the challenges of a hectic school year.”
But first, this news update. Here’s Craig Fritz.
News Update
Fritz: Research funded by NIH has found that adding CT scans to standard screening procedures may help emergency room staff quickly determine which patients complaining of chest pain are having a heart attack or may soon have a heart attack, and which patients can be safely discharged. Researchers in the study focused on a condition known as acute coronary syndrome, which includes heart attacks and unstable angina, a condition that often progresses to a heart attack. This syndrome occurs when narrowed or blocked coronary arteries prevent blood from reaching the heart muscle. Since chest pain has many causes, patients are often unnecessarily admitted to the hospital before it is determined that their chest pain is not due to acute coronary syndrome or other serious conditions. A CT scan creates pictures of the coronary arteries, allowing physicians to see whether arteries have major blockages. The study results suggest that CT scans allow hospitals to send many patients with chest pain home sooner without compromising their safety.
Researchers at NIH have found evidence that a unique type of immune cell contributes to multiple sclerosis, also known as MS. Their discovery helps define the effects of one of the newest drugs under investigation for treating MS and could lead to a new class of drugs for treating MS and other autoimmune disorders. In these disorders, the immune system turns against the body’s own tissues. Ongoing clinical trials have shown that the drug appears to help quiet the immune response in MS patients, but its precise effects on the immune system are not fully understood. The study shows that one effect of the drug is to reduce the number of lymphoid tissue inducer cells in the body. These cells are known to promote the development of lymph nodes during fetal life, but their role during adulthood has been unclear. The new study marks the first time that these cells have been implicated in any human autoimmune disorder. Scientists say that while further study is required to confirm the role of these cells in autoimmunity, these results point to the cells as a promising target for the development of new drugs to treat autoimmune disorders, such as MS.
Most children exposed to high levels of alcohol in the womb did not develop the distinct facial features seen in fetal alcohol syndrome, but instead show signs of abnormal intellectual or behavioral development, according to a study by researchers at NIH and in Chile. These abnormalities of the nervous system involved language delays, hyperactivity, attention deficits or intellectual delays. The study authors documented an abnormality in about 44 percent of children whose mothers drank four or more drinks per day during pregnancy. In contrast, abnormal facial features were present in about 17 percent of alcohol exposed children. Fetal alcohol syndrome involves a characteristic pattern of facial abnormalities, growth retardation, and brain damage. Abnormalities seen in children exposed to alcohol prenatally — but who do not have the full pattern of birth defects seen in fetal alcohol syndrome — are classified as fetal alcohol spectrum disorders. Researchers say this study is important because in the absence of the distinctive facial features, health care providers evaluating children with any of these impairments might miss their history of fetal alcohol exposure. As a result, children might not be referred for appropriate treatment and services.
For this NIH news update – I’m Craig Fritz.
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up next, back to school health, both for college campuses and the whole family, and cutting edge research on joint implants. That’s next on NIH Research Radio.
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Advances in adhesive technology for joint replacements
Balintfy: New technology is being studied to help make joint implants work better. Margot Kern reports on how nanotechnology built into joint replacements may help implants last longer in the future.
Kern: More than a million Americans receive an artificial hip or knee replacement each year, and while these devices are intended to last several decades, nearly 17% have to be redone early. Dr. Lyndon Joseph, a program officer at the National Institute of Aging says these “revision” surgeries are often more difficult for patients than the original replacements.
Joseph: To do it a second time is even more traumatic because they have to take out the implant, give you a big dose of antibiotics and painkillers and so you’re basically laid up in a hospital for an extended period of time up to weeks to months. What happens during that time is that you have a significant loss of musculature, decrease in the skeletal muscle, decrease in bone mass and so the rehab therapy that’s going to be needed after that is even extended. So you getting back to your independence the timeframe is a little bit longer when you have to do revision surgery.
Kern: Chemical engineers at the Massachusetts Institute of Technology have come up with a new way to make hip and knee replacements more durable. Currently, surgeons use a fixative called bone cement to adhere a patient’s existing bone into the socket of an artificial hip or knee. But, this cement bond can give way over time. MIT engineers have recently developed a coating for the implanted device that will help with adhesion.
The coating consists of a very thin layer of proteins called growth factors. These special factors can cause stem cells --found in a patient’s bone marrow-- to turn into bone-producing cells or osteoblasts. The goal is for these newly generated osteoblasts to then fill in the spaces around the implant with bone, thereby eliminating the need for cement.
Joseph: With this technology here, using these growth factors, the implantation then actually fuses better with the bone and so you have a stronger connection with implants and the bone and the structure around it so it’s more stable and it lasts a little bit longer.
Kern: Previous attempts have been made to release growth factors onto implants without much success. In one case the coating was too thick and unstable, causing it to break away from the implant. In another, surgeons directly injected growth factors onto the implant, but most drained away from the site. Dr. Joseph explains some of the issues with local drug delivery.
Joseph: The issue that they’re working out here is to get the perfect timing of the release of these growth factors because that’s key as well. [0:06:16] [Phonetic] If you’ll back up a little bit with the technology is that on top of these devices, these implants, they’re layering this very, very thin film with all these drugs. It’s a different way of drug delivery. It’s a local way of drug delivery instead of a systemic way. So the problem with doing a local delivery is that you don’t want too much of the drugs being exposed at the wrong time. And so what they’re working out here is a timing issue.
Kern: MIT engineers are hoping to get around this issue by using a method called layer-by-layer assembly in which all the different growth factors are laid down one layer at a time until the appropriate thickness is achieved. The coating can be as little as one micron--that’s one one-thousandth of a millimeter. And because they can make the coating so thin, they can release only the exact amount of drug needed. So far, they’ve achieved promising results in several animal studies. Still, Dr. Joseph says the technology is years away from making it to the operating room.
Joseph: It’s still in the discovery phase. It’s still in the animal phase. The big thing is when they then translate it into the human phase that’s going to be the big bang for the buck. When this is going to happen, it’s anybody’s guess, but I know that there’s a lot of work going on out there not only NIH sponsored but industry sponsored work.
Kern: Dr. Joseph says participation in clinical trials will be important in helping the FDA quickly determine whether the product will be effective in patients.
Joseph: When it goes into the clinical trial phase into human that’s when – you know, so people who are really into research and really into advance in research, you know, should actually look for clinical trials and volunteer for these clinical trials to test the effectiveness and the efficacy of these technologies.
Kern: Dr. Joseph speculates on how this new technology might impact patients in the future.
Joseph: In the long run, I think it’ll be easier for people to decide whether or not to go ahead with this, the surgery because as you pointed out, it is a major surgery and you’re laid up for quite some time. And so having this would actually get you to be involved in physical therapy a lot earlier so you have a lot less decline in your strength and your power. So I think it will improve the whole process a lot quicker than it is right now and that’s the whole point of science is to always keep pushing the envelope and making things a lot easier and a lot better for the public.
Kern: For more information about new joint replacement technology, visit www.nia.nih.gov.
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Colleges and communities can reduce alcohol-related harm to students
Balintfy: Students going back-to-school probably aren’t thinking about joint replacements, but in the first timely story Wally Akinso reports that coordinated strategies can help colleges and their communities protect students from the harms of high-risk drinking.
Akinso: Strategies that address alcohol availability, alcohol policy enforcement and drinking norms can help colleges and communities reduce alcohol related harm to students. These coordinated strategies were part of the Study to Prevent Alcohol Related Consequences, known as SPARC. Dr. Ralph Hingson, an expert on alcohol prevention at the NIH, explains the purpose of SPARC.
Hingson: The purpose of this study was to assess the effectiveness of a multi-component of college community collaborative intervention to reduce high risk drinking and negative consequences from drinking.
Akinso: Risks and consequences associated with drinking can include car accidents, DUIs or DWIs, the need for medical treatment as a result of drinking, physical fights, and sexual assaults. Dr. Hingson says the study examined environmental approaches that had shown promise in communities but had not been thoroughly studied on college campuses.
Hingson: What they did was they selected 10 universities in North Carolina. And match them according to their size and their readiness to engage in activities to prevent these drinking problems; and then randomly allocated half of them to receive the intervention.
Akinso: Within the five campuses in the intervention group, many strategies were similar. Dr. Hingson says there was a focus on specific areas of intervention.
Hingson: Reducing the availability of alcohol, minimizing harm from alcohol misuse, altering social norms and increasing alcohol price and restricting marketing. And then specifically within the schools the most common interventions were restricting provision of alcohol for underage and intoxicated students, coordinating campus and community police enforcement, restricting alcohol purchase and possession, restricting alcohol and campus events, and they implemented consistent disciplinary actions for alcohol policy violations.
Akinso: For three years, researchers surveyed students about their drinking habits and resulting harms and found small but significant decreases in two categories.
Hingson: Well they didn’t find significant changes with regards to drinking, but they did find significant reductions in consequences that those who misused alcohol experienced themselves and they also saw a reduction in injuries to other people.
Akinso: Dr. Hingson believes that these modest reductions in harm will translate into many students being helped by the intervention. For example, a college campus with 11,000 students, researchers estimate the SPARC intervention will result in 228 fewer students experiencing at least one severe consequence of drinking over the course of a month and 107 fewer students injuring others due to alcohol use during the year. He added that an important future step will be to focus on methods to promote adoption and implementation of the SPARC intervention in colleges across the US. For more information on the SPARC intervention, visit www.niaaa.nih.gov. For NIH Radio, this is Wally Akinso.
Balintfy: Another back-to-school health topic is next on NIH Research Radio.
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Parents can help their child have a healthy school year
Balintfy: It’s just a few weeks away. Back to school time. For many routines will change with more activities to fit in each day. But those new activities may not include healthy habits. So health experts are emphasizing that the busy back-to-school season is also a time to remember healthy eating a physical activity. I’m talking with Dr. Griffin Rodgers, director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. And Dr. Rodgers, why is it important for parents to remind their children about health this time of year?
Rodgers: A new school year signals time for kids to be with friends, study new subjects, and get involved in after-school activities. With so many demands on you and your child during the school year, it is easy for healthy eating and physical activity habits to take a back seat. We want to remind parents and their children that they don’t have to let busy school days and after school activities lead to skipped meals and inactivity. In fact, healthy eating and regular physical activity may help the whole family meet the challenges of a hectic school year.
Balintfy: So how can parents help their children stick with healthy eating and physical activity habits during the school year?
Rodgers: Healthy eating and regular physical activity are two very important ways to help your child feel energized, learn better and stay alert during the school day.
Whether your child eats breakfast and lunch at school or you pack these meals for him or her, these meals should provide your child with about two-thirds of the nutrients they need for the day.
When your child buys meals at school, review the menu with them and help them choose healthier foods like a turkey sandwich on whole-grain bread. Encourage your child to think about what he or she drinks, too. Choose water, fat-free, or low-fat milk more often, instead of soda or other sweetened drinks or juices.
Balintfy: And what about physical activity Dr. Rodgers?
Rodgers: Children should be active every day, whether they play sports, take P.E. or get from place to place by walking or bicycling. Make sure your child gets at least 60 minutes or more of physical activity on most, preferably all, days of the week. If your child is not used to being active, encourage him or her to start with what they can do and build up to 60 minutes a day. Some activities that your child might enjoy trying include, jumping rope, playing volleyball or playing catch. Replace after-school TV watching and video game use with physical activity. Help your child get involved with activities at school or in your community. Volunteer as a family to clean up a local park or playground.
Balintfy: What can a parent do if his or her child is overweight or obese?
Rodgers: Children grow at different rates at different times, so it is not always easy to tell if a child is overweight or obese.
We know that overweight and obesity tend to run in families. In addition to genes, the world in which children and their families live and work and play may contribute to overweight and obesity.
If your child is overweight or obese, he or she is at greater risk for developing serious health problems such as diabetes, high blood pressure, kidney disease and other health issues. Helping children achieve and maintain healthier lifestyle habits, such as more physical activity and healthy eating, may lower their chances of developing diabetes, high blood pressure, and other serious health problems as adults.
If you think that your child is overweight or obese, talk to your health care provider. He or she can tell you if your child’s weight, height, and blood pressure are in a healthy range.
Balintfy: What are some quick and easy healthy meal and snack ideas parents can prepare for their children?
Rodgers: Here are some quick and easy meal and snack ideas parents can prepare for their children during the school year: Small deli sandwiches or subs made with lean turkey, chicken without the skin, or beef with mustard and a little low-fat mayonnaise. Whole-grain bread served with low-fat cheese, peanut butter, or soy nut butter. Sliced apples, oranges, and pears. Fresh, frozen, or canned vegetables or fruit served plain or with low-fat yogurt. Homemade fruit smoothies made with fat-free milk or yogurt and frozen or fresh fruit. Low-fat yogurt topped with fruit or pre-cut vegetables with low-fat dip or salsa are also healthy options.
Balintfy: What resources are available to help parents keep their child healthy during the school year?
Rodgers: The NIH has many resources to help parents keep their child healthy and safe during the school year.
For more information in English or Spanish on children, healthy eating and physical activity, visit the Weight-control Information Network at www.win.niddk.nih.gov.
To learn more about managing diabetes in youth, visit the National Diabetes Education Program at www.yourdiabetesinfo.org.
For more information about high blood pressure and children, visit the National Kidney Disease Education Program at www.nkdep.nih.gov.
Balintfy: Are there other examples or publications that have more resources, Dr. Rodgers?
Rodgers: Here are a couple of other examples of important pamphlets or documents that are available. One is titled “When Your Child is Diagnosed with Diabetes: Parents’ Questions for the Health Care Team.” This provides questions for parents to ask their child’s health care team when the child is diagnosed and for follow-up care. Another, “Helping the Student with Diabetes Succeed: A Guide for School Personnel” now, this comprehensive resource guide helps students with diabetes, their health care team, school staff, and parents work together to provide optimal diabetes management in the school setting. Another is “High Blood Pressure and Children: What Parents Need to Know.” This provides parents tips to keep their child’s blood pressure in a healthy range. And finally, “Being Healthy is a BIG Deal!” This is a pamphlet that offers parents and children healthy eating and physical activity tips to follow during the school year.
Balintfy: Thank you very much Dr. Griffin Rodgers. Again those websites Dr. Rodgers mentioned for more information are www.win.niddk.gov, www.yourdiabetesinfo.org and www.ndep.nih.gov.
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Balintfy: That’s it for this episode of NIH Research Radio. Please join us again on Friday, August 24 when our next edition will be available. In that next episode:
“Research is now showing us that chronic pain goes beyond the pain itself. That when people have pain for many years, in fact is has detrimental effects on their brain, it can lead to some cognitive impairment, that people can’t remember things as well as they did before. And we find that when we look at the brain in fact it’s kind of like a premature aging of the brain that we see with somebody who has chronic pain.”
If you have any have story suggestions for a future episode, or questions or comments about this program, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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