i on NIH Vodcast
May 6, 2011
“i on NIH” Vodcast Episode #0026
Welcome to “i on NIH”!
In this month’s episode, a plan for obesity research, the history of heart valves, and diabetic eye disease
From the National Institutes of Health in Bethesda, Maryland – America’s premiere medical research agency – this is “i on NIH”!
Covering health-research topics important to you and the nation, this public service vodcast is your information source from inside all 27 institutes and centers at NIH.
Half an hour, once a month, we’ll show you the excitement of advances and the important information that comes from medical research. And now, here’s your host, Joe Balintfy.
Host: Welcome to episode 26 of I on NIH thanks for joining us. We have three stories for you in this episode. This first is an NIH Director, Dr. Francis Collins discussing the importance of obesity research and the Strategic Plan for NIH Obesity Research.
Collins: Obesity is a severe and increasingly severe public health problem in the United States and across the world. In the U.S., roughly one-third of adults are considered obese, by our current standards, and about 17 percent of children. And the prospects of this, for what it will do in terms of health care, in terms of human longevity, are of deep concern. So this is a very high priority for the National Institutes of Health to address with an effective strategic plan.
If the NIH has its mission to try to promote human health, obesity is right in the middle of that. So of all the organizations you can think of probably NIH appears on that very short list of the most important ones to tackle this problem. And we embrace that. And aim to try to live up to that responsibility by promoting excellent science that gives rigorous results that then can be applied to the public.
I think some people look at the obesity problem and say, well, you know, it’s just ‘cause people eat too much and don’t get enough exercise, so what’s the science here? Well, there’s a lot of science. And a lot of things that we could learn more about in a way that would help the situation beyond simply wagging fingers at people and telling them to behave.
The strategic plan is rather sweeping in its set of goals. Going all the way from basic science understanding of what are those signals, that actually trigger hunger and satiety, and also exactly what are those genetic influences that play a role in the tendency towards obesity. And what about the microbes that may be playing a role as well.
But it goes much further than that, to questions about the environment. What influences there that we know about, or don’t know about, are also triggering the risk of obesity. But it focuses quite heavily, then, on interventions. How do you design trials with creative new ideas about how to prevent or treat obesity. And then, once you’ve identified possible strategies, how do you develop an approach to find out whether they work in the real world? ‘Cause a clinical trial under very closely controlled circumstances is exciting if it gives you a good result, but it doesn’t guarantee that that’s something you can apply to millions of people in a less controlled situation. That’s part of NIH’s job, too. Is to look at that kind of implementation question, and that’s very much part of this plan.
Obesity has many health effects that are potentially quite serious. Most notably diabetes. That the very rapid rise in the incidence of so-called type 2 adult-onset diabetes is largely attributable to the epidemic of obesity. The fact that this disease, which we used to call ‘adult-onset diabetes,’ now is turning up in kids who are nine or ten or 11 years old, because of obesity, is truly frightening. ‘Cause diabetes has a wide range of long-term effects, in terms of blindness, in terms of kidney failure, in terms of heart attacks, strokes, amputations.
Obesity also predisposes, obviously, to lots of musculoskeletal problems in terms of joints that get worn down. The need for joint replacements. It predisposes to heart attacks to strokes.
The National Institutes of Health is our nation’s investment in biomedical research, to try to understand the causes of disease, and the ways to prevent and treat. Obesity is a very significant cause of current illness in our country, and becoming more significant all the time. The National Institutes of Health is determined to take the resources that we’ve been given by the taxpayers and learn everything we can about this epidemic in order to turn it around. We aim to be no less than completely innovative ambitious, bold and creative in generating the evidence that we need to get the answers that will lead to a better future.
Host: For more from Dr. Collins on obesity research and the strategic plan, listen to episode 131 of the NIH Research Radio podcast. You can find that episode at www.nih.gov/news/radio.
In this next segment, we hear about heart valves. The DeWitt Stetten Medical Museum, which collects, preserves, and interprets biomedical research instruments and memorabilia, especially those related to the NIH, recently participated in a AAAS Webinar. Here’s the video showing and explaining the early use of heart valve surgery at the National Institutes of Health.
Lyons: I’m Michele Lyons. I’m the curator at the NIH Stetten Musuem. We’re part of the Office of NIH History. And this is Hank Grasso, who is the other half of our team. He is our exhibit content developer and designer. Today we’re going to be showing you some objects from an exhibit which will be opening up at the end of March on the development of artificial heart valves.
Grasso: NIH became a huge center in the heart valve evolution because the operating facility had the ability to capture data in a way that no one else could. The surgeons of the time remarked that they could do any catheterization process right during an operation. So models were sent here, different kinds of prototypes from all over, to see how well they held up and how well they were relatively performing.
Lyons: Nina Braunwald developed this—it’s a mitral valve—it’s made out of polyurethane. Braunwald was significant because she was the first woman thoracic surgeon. When she designed it— she designed it to mimic a natural heart valve, so you see it has a little slit in the middle, so you could open up and close just like a real heart valve does. It was situated in the heart using the dacron ties. It was the first mitral valve successfully implanted in a human in 1960. The patient lived for a little over a month, but it proved that that valve could be successfully replaced.
Grasso: These are an example of a ball and caged valve. What is unique is that to make them less thrombogenic or to generate less blood clots, Dr. Braunwald would sew a fabric covering over the metal stents that hold the ball in place—the cage. This valve—the Reece-Hancock—it is a valve from a pig, a porcine valve that is stretched over stents that hold it in position so that it can be installed with a sewing ring. The current day research might best be that of Dr. Keith Horvath. His research is in the use of a self-expanding stent to which he sews a porcine or pig valve. The flexible stent is a design that springs open to be a structural support, but collapses to allow it to be threaded through a catheter. In order to get from a large diameter of the expanded stent with the valve attached to the small diameter required to go through the catheter, this unique little apparatus was designed to collapse the diameter. You press down on the arm to slowly decrease the opening within this container. So you thread the stent and valve inside and then compress it in order to reduce its diameter for use. The other part that is remarkable about Dr. Horvath’s work is the use of a real time MRI to be able to see and measure exact sizes of valves and the details as he’s operating.
Host: Learn more about the history of biomedical research at the NIH Office of History website: history.nih.gov.
And in this third and final segment for this episode, we feature information on diabetic eye disease.
Narrator: A doctor explains diabetic eye disease, and how to treat the condition.
Dr. Rachel Bishop: Diabetes is a disease that affects blood vessels, and it affects blood vessels all over the body. Unfortunately, diabetic damage in the eye leads to vision loss. And what happens is these abnormal blood vessels often leak; they leak fluid, they leak oils, and they can bleed.
And there are various treatments for diabetic eye disease. It’s very important for patients who have diabetes to control their blood sugars well, because that is the most effective way of avoiding damage and loss of vision.
If a person has diabetic eye disease, there are a few treatments we may be recommending. One of them uses a laser to help control the swelling or growth of abnormal blood vessels. Another involves injections of medicines either into the eye or around the eye.
Patients with diabetic eye disease also get cataracts at a higher rate, and should not be surprised if their eye doctor talks to them about cataracts and possible improvement of vision with cataract surgery.
People with diabetes need to see an eye care professional at least once a year. The reason is that the early changes from diabetes oftentimes are not recognized by the patient, by signs of any vision loss. They will be seeing fine, and there can be early disease in the eye that can only be detected by a dilated eye exam.
For more information about eye health, about finding an eye care professional, or about locating an organization that can provide financial assistance for eye care, please refer to our website. That is www.nei.nih.gov.
Host: That website again is www.nei.nih.gov. And that’s it for this episode on I on NIH. If you’d like to see or forward individual segments from this program, they’re available on YouTube. Check out the NIHOD channel. Thanks for tuning in and please watch again next time. For I on NIH, I’m Joe Balintfy.
Narrator: “I on NIH” is a public service vodcast from the Department of Health and Human Servives. Produced by NIH News Media Branch, of the Office of the Director, Office of Communications and Public Liaison. Thanks for tuning in. We’ll be back again next month with another episode of “I on NIH.”
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