Donepezil Alzheimer

Cessation of donepezil is associated with clinical decline in patients with moderate-to-severe Alzheimer's disease compared to continuation of donepezil or addition or substitution of memantine

1. Pierre N Tariot

1. Banner Alzheimer's Institute, Phoenix, Arizona, USA

1. Correspondence to: Pierre N Tariot
   Banner Alzheimer's Institute, 901 E Willetta ST, Phoenix, Arizona 85006, USA;Pierre.tariot{at}bannerhealth.com

Commentary on:Donepezil and memantine for moderate-to-severe Alzheimer's disease[CrossRef][Medline][Web of Science]

Context

More than half of persons with Alzheimer's disease are at moderate or severe stages, and evidence defining best practice for them is limited. Previous clinical trials in these patients, as summarised by Howard et al,1–5 have shown that treatment with donepezil or memantine only, or the addition of memantine to donepezil, confers benefit in cognition and daily function. Building upon these, Howard and colleagues aimed to address the relative benefit of continuing donepezil, adding or substituting memantine, or stopping donepezil in these patients./.../

A Ultima maravilha da Ciência!

Recomendado por minha amiga CONCEIÇÃO ANDRADE, esposa do JOHN BRISCOE que vivem nos EEUU.
eu fui ao Atacama desert com meu grupo de astronomia de Brasilia, (but not to this telescope site, we went to another telescope site).  
foi magico!

 A Ultima maravilha da Ciência!

 

Inaugurada no dia 13 deste mês, a última maravilha da ciência, na incessante procura das nossas origens.

 -   Fabuloso! 

 http://dotsub.com/view/08a2457e-7d67-4fa0-9715-5e5d86d037cb#.UUUEvtF3l7Y

 

Grid cells

Sellected by the AMICOR Maria Inês Reinet Azambuja

SCIENCE

PROFILES IN SCIENCE

A Sense of Where You Are

Brian Cliff Olguin for The New York Times

May-Britt Moser with Thelma, one of the lab rats used in the research she and her husband, Edvard I. Moser, are conducting.

3 more images

By JAMES GORMAN

Published: April 30, 2013

TRONDHEIM, Norway - In 1988, two determined psychology students sat in the office of an internationally renowned neuroscientist in Oslo and explained to him why they had to study with him.

Unfortunately, the researcher, Per Oskar Andersen, was hesitant, May-Britt Moser said as she and her husband, Edvard I. Moser, now themselves internationally recognized neuroscientists, recalled the conversation recently. He was researching physiology and they were interested in the intersection of behavior and physiology. But, she said, they wouldn't take no for an answer.

"We sat there for hours. He really couldn't get us out of his office," Dr. May-Britt Moser said.

"Both of us come from nonacademic families and nonacademic places," Edvard said. "The places where we grew up, there was no one with any university education, no one to ask. There was no recipe on how to do these things."

"And how to act politely," May-Britt interjected.

"It was just a way to get to the point where we wanted to be. But seen now, when I know the way people normally do it," he said, smiling at the memory of his younger self, "I'm quite impressed."

So, apparently, was Dr. Andersen. In the end, he yielded to the Mosers' combination of furious curiosity and unwavering determination and took them on as graduate students.

They have impressed more than a few people since. In 2005, they and their colleagues reported the discovery of cells in rats' brains that function as a kind of built-in navigation system that is at the very heart of how animals know where they are, where they are going and where they have been. They called them grid cells.

"I admire their work tremendously," said Eric Kandel, the Nobel laureate neuroscientist who heads the Kavli Institute for Brain Science at Columbia and who has followed the Mosers' careers since they were graduate students./.../

Risco e Morbidade da Atividade Sexual

Materia selecionada pelo AMICOR Dr. Jorge Gomes, especialista em Saúde Ocupcional e colega de turma (1960) da Dra. Valderês Robinson, minha esposa.

El Observatorio de Salud y Seguridad Ocupacional. Río Cuarto Pcia. de Córdoba
observatoriodesaludyseguridad@arnet.com



MEDICINA DEL TRABAJO CARDIOLÓGICA
XXXXXXXXXXXXXXXXXXXXXX
Las personas que fallecen durante el acto sexual suelen estar acompañadas por una pareja distinta de la habitual
JANO · 25 Abril 2013
Expertos subrayan que la prueba de esfuerzo que se realiza al enfermo cardiaco tras sufrir un infarto es un buen método para medir el estado de su corazón, ya que el desgaste energético que ésta requiere es superior al de la práctica sexual.
Tras sufrir un infarto de miocardio, el paciente cardiaco se replantea sus quehaceres cotidianos y las probables secuelas que de ellos se derivan. Según asegura Javier Andrés Novales, coordinador de los servicios de Cardiología de los hospitales San Eloy (Barakaldo) y San Juan de Dios (Santurtzi), “no es ajeno a este planteamiento hacerse algunas preguntas y temores sobre la vida sexual. Para encontrar soluciones positivas es necesario despojarse de todos los tabúes o de la vergüenza que se pueda experimentar al consultar estos temas con el médico o el psicólogo”.
El Dr. Novales, que pronunció una conferencia al respecto en el foro Encuentros Con la Salud, señala que “la ausencia de actividad sexual en la pareja tras un infarto de miocardio puede ser consecuencia del miedo a la muerte durante el coito”.
“Sin embargo”, prosigue, “los casos de fallecimiento durante el acto sexual ocurren en un porcentaje muy bajo. En un estudio sobre 5.559 casos de muerte repentina por causas no traumáticas, sólo 34 se habían producido durante el coito y se debían a motivos cardiológicos. Es necesario destacar que en 27 de esas 34 relaciones, la persona fallecida estaba realizando el acto sexual con una pareja distinta de la habitual. Indudablemente, en el desenlace influye de forma significativa el nerviosismo, la mayor excitación, el sentimiento de culpa, la necesidad de quedar bien, etc." Por otro lado, este especialista hace hincapié en que “los miedos y ansiedades que surgen con más frecuencia respecto a la vida sexual se refieren al esfuerzo físico que la actividad requiere, ya que el paciente suele tener miedo a que el coito suponga un riesgo importante para su corazón. Para tranquilidad de los enfermos, hay que decir que parece demostrado que los gastos energéticos durante el acto sexual son similares a los que requiere subir dos pisos de escaleras. La frecuencia cardiaca del coito es inferior a la que se produce durante otras actividades normales de la vida cotidiana, y el esfuerzo físico que precisa se podría calificar de moderado, lo que en principio no traería ninguna complicación”. Entrenamiento psicológico En lo que se refiere al momento idóneo para reanudar las relaciones sexuales, el Dr. Novales entiende que “ésta ha de retomarse tras un entrenamiento físico y psicológico adecuado y progresivo. Gracias a esta planificación se aprende a detectar cuáles son las respuestas físicas del cuerpo después de un esfuerzo. Desde un punto de vista psicológico, el entrenamiento llevará al paciente a reconocer cuáles son sus relaciones emocionales nocivas y cómo controlar estas últimas a través de métodos de respiración y relajación”.
La prueba de esfuerzo que se realiza al enfermo cardiaco tras sufrir un infarto es una buena fórmula para medir el estado de su corazón, ya que el desgaste energético que ésta requiere es superior al de la práctica sexual. El experto advierte, además, de que "uno de los problemas que se detecta frecuentemente son los estados de impotencia y de frigidez. Ambos pueden estar motivados por el tipo de tratamiento farmacológico o por la descompensación psicológica provocada por la enfermedad cardiaca. Cualquiera de las dos situaciones puede provocar síntomas de depresión susceptibles de ser tratadas por un psicólogo”.

Physician Impairment

Identification of Physician Impairment FREEONLINE FIRST

Julius Cuong Pham, MD, PhD; Peter J. Pronovost, MD, PhD; Gregory E. Skipper, MD

[+] Author Affiliations

JAMA. 2013;():1-2. doi:10.1001/jama.2013.4635.

Text Size: A A A

Published online April 29, 2013

Article

References

When a critical event occurs in most high-risk industries (such as airlines, nuclear power, or railways), a detailed investigation examines a variety of system and individual factors (such as fatigue and substance abuse), that caused or contributed to the event. Directly involved individuals are commonly tested for alcohol and other drugs. Airplane pilots and truck drivers are tested following crashes and near misses.¹ Some law enforcement officers are tested following fatal shooting incidents.

Mandatory alcohol-drug testing for clinicians involved with unexpected deaths or sentinel events is not conducted in medicine. Yet alcohol, narcotic, and sedative addiction is as common among physicians as the general population,² and physicians are as susceptible to the effects of prescription and nonprescription drugs and alcohol as any other person. According to a 2006 article, “at least one-third of all physicians will experience, at some time in their career, a period during which they have a condition that impairs their ability to practice medicine safely.”³ Coupled with the estimate that one-third of all hospital admissions experience a medical error,⁴ physician impairment seems to be a possible contributor to patient harm./.../

2599 - AMICOR 15

Betatrophin

Aloyzio AchuttiemAMICOR - Há 19 horas

Potential diabetes breakthrough Harvard researchers discover hormone that spurs beta cell production April 26, 2013 [image: betatrophin_cell] Betatrophin causes a specific increase in pancreatic β cell replication. Betatrophin is a secreted protein expressed in liver and fat. The increase in β cell replication and mass improves glycemic control. (Credit: Peng Yi, Ji-Sun Park, Douglas A. Melton/Cell) Researchers at the Harvard Stem Cell Institute(HSCI) have discovered a hormone that holds promise for a dramatically more effective treatment of type 2 diabetes, a metabolic illness afflic... mais »

bypassing the blood-brain barrier,

Aloyzio AchuttiemAMICOR - Há 19 horas

Researchers bypass the blood-brain barrier, widening treatment options for neurodegenerative and central nervous system diseaseApril 26, 2013 [image: murine_graft_model] Sagittal MRI of a patient following endoscopic reconstruction of a skull base defect using a nasal mucosa graft (dotted white line; arrow denotes the proposed transmucosal pathway for HMW agents from the nose into the CNS through the graft) (credit: Benjamin S. Bleier et al./PLoS ONE) The first known method to permanently bypass the blood-brain barrier*, using mucosa, or the lining of the nose, has been demonstrated b... mais »

Sem título

Aloyzio AchuttiemAMICOR - Há um dia

Alzheimer’s researchers creating ‘designer tracker’ to quantify elusive brain protein, provide earlier diagnosisApril 26, 2013 *[+]* Dual channel fluoresecence microscopy of Alzheimer’s disease brain reveals presence of extracellular Abeta- (red) and intracellular tau- (green) bearing lesions (credit: Kristen E Funk, PhD) By using computer-aided drug discovery, an Ohio State Universitymolecular biochemist and molecular imaging chemist are collaborating to create an imaging chemical that attaches predominantly to tau-bearing lesions in living brain. Their hope is that the “designer” t... mais »

Bom Jardim - Ivoti

Aloyzio AchuttiemAMICOR - Há um dia

SÁBADO, 27 DE ABRIL DE 2013 Bom Jardim-Ivoti no palco da história *Meu amigo, colega e parente, José Antônio Brenner cita ascendentes nossos (meus por dois costados)* * * Capa No próximo dia 2 de maio, na 31ª Feira do Livro de Ivoti, haverá o lançamento de *Bom Jardim-Ivoti no palco da história*, Editora Feevale, um substancioso livro de 520 páginas. A obra, que conta com a participação de vários autores e autoras, registra, sob diversos enfoques, a história da colônia alemã de Bom Jardim, iniciada em 1826, quando era chamada*Berghahnerschneiß*, a Picada dos Berghahn, primit... mais »

Psychiatry needs its Higgs boson moment

Aloyzio AchuttiemAMICOR - Há um dia

New post on *Mind Hacks*2013-04-27 Spike activityby vaughanbell *Quick links from the past week in mind and brain news:* Psychiatry needs its Higgs boson moment says and article in *New Scientist* which describes some interesting but disconnected findings suggesting it 'aint going to get it soon. *Wall Street Journal* has an overenthusiastic article on how advances in genetics and neuroscience are 'revolutionizing' our understanding of violent behavior. Not quite but not a bad read in parts. The new series of BBC Radio 4 wonderful series of key studies in psychology, *Mind Changers*, h... mais »

Gut Flora

Aloyzio AchuttiemAMICOR - Há 2 dias

Intestinal Flora Again Implicated in CAD; but This Time, Also CV Events Steve Stiles Apr 25, 2013 *Our gut microbes are the biggest endocrine organ in our body. They can make biologically active compounds, and they contribute to disease processes.* CLEVELAND, OH* —* A major dietary source of choline provided in abundance by egg yolks and meat can, after conversion by intestinal bacteria, raise plasma levels of trimethylamine-N-oxide (TMAO), suggests a report published this week[1]. It also supports earlier evidence that circulating TMAO is proatherogenic and may have potential as a ... mais »

The Most Distant Supernova

Aloyzio AchuttiemAMICOR - Há 2 dias

*Supernova Superstar: The Most Distant and Important One Yet* By Michael D. LemonickApril 26, 2013 [image: This image of Supernova SN 1987A, one of the brightest stellar explosions since the invention of the telescope, is based on observations done with the High Resolution Channel of Hubble’s Advanced Camera for Surveys and was released on December 10, 2012.] Astronomers can make a surprising amount of hay over relatively small observations. That faint hiss in your AM radio that just seems like spotty reception? It’s actually the cosmic background radiation pouring in from all ov... mais »

glyphosate

Aloyzio AchuttiemAMICOR - Há 2 dias

Heavy use of herbicide Roundup linked to health dangers: study Thursday, April 25, 2013 Related MedlinePlus Page - Pesticides By Carey Gillam (Reuters) - Heavy use of the world's most popular herbicide, Roundup, could be linked to a range of health problems and diseases, including Parkinson's, infertility and cancers, according to a new study. The peer-reviewed report, published last week in the scientific journal Entropy, said evidence indicates that residues of "glyphosate," the chief ingredient in Roundup weed killer, which is sprayed over millions of acres of crops, has been ... mais »

antipsychotic drugs activate a wide range of genes

Aloyzio AchuttiemAMICOR - Há 2 dias

Bipolar Disorder Drugs May 'Tweak' Genes Affecting Brain Study offers clues on causes of condition and how commonly prescribed meds work Thursday, April 25, 2013 [image: HealthDay news image] Related MedlinePlus Pages - Bipolar Disorder - Genes and Gene Therapy - Medicines THURSDAY, April 25 (HealthDay News) -- Medications taken by people with bipolar disorder may actually be nudging hundreds of genes that direct the brain to behave more normally, according to new research. The study suggests that antipsychotic drugs activate a wide range of genes, changing their function, s... mais »

CD33

Aloyzio AchuttiemAMICOR - Há 2 dias

Contact: Jules Asher 301-443-4536 Suppressing protein may stem Alzheimer's disease processRunaway regulator clogs removal of toxic debris – NIH funded study Scientists funded by the National Institutes of Health have discovered a potential strategy for developing treatments to stem the disease process in Alzheimer’s disease. It’s based on unclogging removal of toxic debris that accumulates in patients’ brains, by blocking activity of a little-known regulator protein called CD33. “Too much CD33 appears to promote late-onset Alzheimer’s by preventing support cells from clearing out tox... mais »

Carta ao Editor dos ABC

Aloyzio AchuttiemAMICOR - Há 5 dias

*Recebi hoje o número de março dos ABC onde saiu a Carta ao Editor enviada pela AMICOR Maria Ines Reinert Azambuja.* *A flecha identificadora aponta equivocadamente para Dr. Flávio Behr que estava a meu lado.* http://www.arquivosonline.com.br/2013/10003/pdf/10003014.pdf Na versão em Inglês o equívoco não existe. http://www.arquivosonline.com.br/2013/english/10003/pdf/i10003014.pdf

SAFETY AND HEALTH AT WORK 2013

Aloyzio AchuttiemAMICOR - Há 6 dias

*Appointed by the AMICOR Berenice Goelzer* * * WORLD DAY FOR SAFETY AND HEALTH AT WORK 2013 [image: thumbnail image: World day for Safety and Health at Work 2013] The Cochrane Reviews highlighted here are freely available while this Special Collection is featured on The Cochrane Library homepage. INTRODUCTION The International Labour Organisation celebrates the World day for Safety and Health at Work on the 28th of April, with a theme for 2013 of prevention of occupational diseases (www.ilo.org). Labour unions worldwide also commemorate workers who have died at work or as a result of... mais »

Leonhard Euler

Aloyzio AchuttiemAMICOR - Há 6 dias

Leonhard Euler: Google Doodle Honors 306th Birthday of Swiss Mathematician By Olivia B. WaxmanApril 15, 20136 Comments - - - - - - inShare5 - Send to Kindle [image: Picture 169] Born Apr. 15, 17o7, in Basel, Switzerland, he was the son of a Calvinist minister who started college at the University of Basel at 13 and earned his master’s degree in philosophy by age 16. While Frederick the Great invited him to join the Berlin Academy at one point, he spent most of his career working in St. Petersburg, Russia.Today’s... mais »

“Paisagem cerebral”

Aloyzio AchuttiemAMICOR - Há uma semana

“Paisagem cerebral” do Brasil é fotografada da Estação Espacial [image: 7] Enquanto a Estação Espacial Internacional orbitava sobre a América do Sul, seu comandante, Chris Hadfield, tirou a foto acima. “Eu não tenho ideia de como essa formação brasileira se parece quando vista de perto”, escreveu o astronauta em seu Twitter, “mas, da órbita, é um cérebro”.

Betatrophin

Potential diabetes breakthrough

Harvard researchers discover hormone that spurs beta cell production

April 26, 2013

Betatrophin causes a specific increase in pancreatic β cell replication. Betatrophin is a secreted protein expressed in liver and fat. The increase in β cell replication and mass improves glycemic control. (Credit: Peng Yi, Ji-Sun Park, Douglas A. Melton/Cell)

Researchers at the Harvard Stem Cell Institute(HSCI) have discovered a hormone that holds promise for a dramatically more effective treatment of type 2 diabetes, a metabolic illness afflicting an estimated 26 million Americans.

The researchers believe that the hormone might also have a role in treating type 1, or juvenile, diabetes.

The work was published by the journal Cell.

The hormone, called betatrophin, causes mice to produce insulin-secreting pancreatic beta cells at up to 30 times the normal rate. The new beta cells only produce insulinwhen called for by the body, offering the potential for the natural regulation of insulin and a great reduction in the complications associated with diabetes, the leading medical cause of amputations and non-genetic loss of vision./.../

bypassing the blood-brain barrier,

Researchers bypass the blood-brain barrier, widening treatment options for neurodegenerative and central nervous system disease

April 26, 2013

Sagittal MRI of a patient following endoscopic reconstruction of a skull base defect using a nasal mucosa graft (dotted white line; arrow denotes the proposed transmucosal pathway for HMW agents from the nose into the CNS through the graft) (credit: Benjamin S. Bleier et al./PLoS ONE)

The first known method to permanently bypass the blood-brain barrier*, using mucosa, or the lining of the nose, has been demonstrated by researchers in the department of Otology and Laryngology at the Massachusetts Eye and Ear/Harvard Medical School and the Biomedical Engineering Department of Boston University.

The method opens the door to new treatment options for those with neurodegenerative and CNS disease.

Inspired by recent advances in human endoscopic transnasal skull based surgical techniques, the investigators went to work to develop an animal model of this technique and use it to evaluate transmucosal permeability for the purpose of direct drug delivery to the brain.

In this study using a mouse model, researchers describe a novel method of creating a semi-permeable window in the blood-brain barrier using purely autologous (the patient’s own) tissues to allow for higher-molecular-weight drug delivery to the CNS. They demonstrated for the first time that these membranes are capable of delivering molecules to the brain that are up to 1,000 times larger than those excluded by the blood-brain barrier./.../

Alzheimer’s researchers creating ‘designer tracker’ to quantify elusive brain protein, provide earlier diagnosis

April 26, 2013

[+]

Dual channel fluoresecence microscopy of Alzheimer’s disease brain reveals presence of extracellular Abeta- (red) and intracellular tau- (green) bearing lesions (credit: Kristen E Funk, PhD)

By using computer-aided drug discovery, an Ohio State Universitymolecular biochemist and molecular imaging chemist are collaborating to create an imaging chemical that attaches predominantly to tau-bearing lesions in living brain.

Their hope is that the “designer” tracer will open the door for earlier diagnosis — and better treatments for Alzheimer’s, frontal temporal dementia and traumatic brain injuries like those suffered by professional athletes, all conditions in which tangled tau filaments accumulate in brain tissue.

“We’re creating agents that are specifically engineered to bind the surface of aggregated tau proteins so that we can see where and how much tau is collecting in the brain,” said Jeff Kuret, professor of molecular and cellular biochemistry at The Ohio State University College of Medicine. “We think the “tau signature” can be used to improve diagnosis and staging of disease.”/.../

Bom Jardim - Ivoti

SÁBADO, 27 DE ABRIL DE 2013

Bom Jardim-Ivoti no palco da história

Meu amigo, colega e parente, José Antônio Brenner cita ascendentes nossos (meus por dois costados)

Capa

    No próximo dia 2 de maio, na 31ª Feira do Livro de Ivoti, haverá o lançamento de Bom Jardim-Ivoti no palco da história, Editora Feevale, um substancioso livro de 520 páginas.

    A obra, que conta com a participação de vários autores e autoras, registra, sob diversos enfoques, a história da colônia alemã de Bom Jardim, iniciada em 1826, quando era chamadaBerghahnerschneiß, a Picada dos Berghahn, primitivos colonos no local.

     No Estado Novo, a antiga denominação, de raízes anteriores à colonização alemã, foi mudada, em 1938, para Ivoti, que significa flor, em Tupi-Guarani. Por sua antiga denominação e por seu atual nome indígena, Ivoti é chamada a "cidade das flores". 

................................................................................

De Bom Jardim para Santa Maria

    Na corrente migratória das antigas colônias alemãs para Santa Maria, algumas famílias eram originárias  da Freguesia de São Pedro do Bom Jardim.

    Em 1857, dois anos após a morte de Johann Friedrich Böbion (o autor da carta), seu genro Jacob Adamy vendeu suas terras na Picada 48.  Chefiando um grupo familiar de 15 pessoas – esposa, filhos, genro, nora e netos –, ele mudou-se para suas novas terras na região do Pinhal, próxima a Santa Maria. No grupo estavam o genro Peter Daniel Gehm, natural de Katzenbach/Baviera Renana, e o futuro genro, Martin Zimmermann, nascido em Bom Jardim, em 9.11.1831.  Eram parte das 11 famílias pioneiras que fundaram a pequena colônia alemã do Pinhal, hoje Itaara.

    Em 1862, o alfaiate Abraham Cassel, natural de Ulmet/Renânia-Palatinado, deixou Bom Jardim e se estabeleceu em Santa Maria, com a esposa, sete filhos e os sogros.

    Em 1867, foi criado o distrito (freguesia), São Pedro de

Bom Jardim abrangendo, entre outras, a Picada 48 e a Picada Café.

    Luiz Cechella nasceu em 1889, na Picada Café, incluída no citado distrito. Era filho do italiano Luigi Cechella e de Maria Luiza Link, natural de Picada Café. Com seus pais e irmã, ele mudou-se para Santa Maria, casando, no Pinhal, com Amantina Izabella Adamy, em 1909. Junto veio o tio João Link Sobrinho.

    Todos esses geraram extensa e importante descendência em Santa Maria, com valiosa contribuição para o desenvolvimento da cidade e região./.../

Psychiatry needs its Higgs boson moment

New post on Mind Hacks

2013-04-27 Spike activity by vaughanbell Quick links from the past week in mind and brain news: Psychiatry needs its Higgs boson moment says and article in New Scientist which describes some interesting but disconnected findings suggesting it 'aint going to get it soon. Wall Street Journal has an overenthusiastic article on how advances in genetics and neuroscience are 'revolutionizing' our understanding of violent behavior. Not quite but not a bad read in parts. The new series of BBC Radio 4 wonderful series of key studies in psychology, Mind Changers, has just started. Streamed only because the BBC think radio simulations are cute. Reuters reports that fire kills dozens in Russian psychiatric hospital tragedy. Author and psychologist Charles Fernyhough discusses how neuroscience is dealt with in literary fiction in a piece for The Guardian. Nature profiles one of the few people doing gun violence research in the US - the wonderfully named emergency room doctor Garen Wintemute. The Man With Uncrossed Eyes. Fascinating case study covered by Neuroskeptic. Wired reports that scientists have built a baseball-playing robot with 100,000-neuron fake brain. To the bunkers! "Let’s study Tamerlan Tsarnaev’s brain" - The now seemingly compulsory article thatargues for some sort of pointless scientific investigation after some horrible tragedy appears in the Boston Globe. See also: Let's study the Newtown shooter's DNA. Wired report from a recent conference on the medical potential of psychedelic drugs. Adam Phillips, one of the most thoughtful and interesting of the new psychoanalyst writers, is profiled by Newsweek. vaughanbell | April 27, 2013 at 8:39 am | Categories: Linkage | URL: http://wp.me/ptsTD-6Xq Comment    See all comments

Gut Flora

Intestinal Flora Again Implicated in CAD; but This Time, Also CV Events

Steve Stiles

Apr 25, 2013

Our gut microbes are the biggest endocrine organ in our body. They can make biologically active compounds, and they contribute to disease processes.

CLEVELAND, OH — A major dietary source of choline provided in abundance by egg yolks and meat can, after conversion by intestinal bacteria, raise plasma levels of trimethylamine-N-oxide (TMAO), suggests a report published this week^[1]. It also supports earlier evidence that circulating TMAO is proatherogenic and may have potential as a biomarker of later cardiovascular risk.

The new study, actually a pair of prospective clinical studies, complement each other by establishing dietary phosphatidylcholine metabolism by gut flora as a source of circulating TMAO and TMAO levels as predictors of death, MI, and stroke "independent of traditional risk factors, even in low-risk cohorts," according to the authors, led by Dr WH Wilson Tang (Cleveland Clinic, OH).

Their work is detailed in the April 25, 2013 issue of the New England Journal of Medicine. If it sounds familiar, it may be because the same research team published strikingly similar findings two weeks ago in the journal Nature Medicine ^[2], but naming dietary carnitine--also prevalent in red meat--as an ultimate source of TMAO released by intestinal microbiotia.

(Later the same week, heartwire and others reported a meta-analysis^[3] suggesting, notably to a befuddled public, that L-carnitine given as a drug in acute MI could limit infarct size and improve clinical outcomes--proving as little else could that the overall story is more complicated than it seems.The popular press seemed to enjoy itself in covering the study and exploded with stories, of varying accuracy, on how carnitine--also an additive to commercial energy drinks and diet supplements--may help drive the heart-disease risk associated with diets rich in meat)/.../