Long-term obesity leads to greater heart risk, study finds.


Young adults who remain obese for two decades or more double their risk of developing a marker of heart disease in middle age, a study found.

Every year of obesity raises the risk of developing coronary artery calcification, a silent predictor of heart disease with mild to no symptoms, by 2 percent to 4 percent, according to research Wednesday in the Journal of the American Medical Association.

More than one third of U.S. adults ages 20 and older, and 17 percent of children and teenagers, are obese, according to the U.S. National Institutes of Health. About $147 billion a year is spent in the U.S. on obesity-related medical costs, according to a 2011 report. Wednesday’s study is the first to show that how long a person is obese can independently contribute to heart risk, said Jared Reis, the lead study author.

“What our study suggests is if we’re measuring only body mass index and waist circumference we may be underestimating the health risks of obesity by not measuring the duration,” Reis, an epidemiologist at the NIH’s National Heart, Lung, and Blood Institute in Bethesda, Md., said in a telephone interview.

Researchers looked at 3,275 adults ages 18 to 30 years who weren’t obese at the beginning of the study in the mid-1980s. Those in the study were given computed tomography scans to detect coronary artery calcification over 25 years. Their obesity and abdominal obesity also was measured.

The researchers found that about 38 percent of those who were obese for more than 20 years and 39 percent of those who had abdominal obesity for that time developed coronary artery calcification compared with 25 percent of those who never became obese and never developed abdominal obesity.

Those in the study who had obesity and abdominal obesity over two decades or more also had their coronary artery calcification progress in their heart.

Obesity is measured using body mass index, or BMI, a calculation of weight and height. For example, a 5-foot, 4-inch woman weighing 175 pounds (80 kilograms) has a BMI of 30. BMI of 30 or more is considered obese, while a BMI of 25 to 29.9 is considered overweight, according to the National Institutes of Health.

Reis said researchers will continue following those in the study to see how many actually develop clinical heart disease.

Source:         http://www.chicagotribune.com

Lasing action in strongly coupled plasmonic nanocavity arrays.


Periodic dielectric structures are typically integrated with a planar waveguide to create photonic band-edge modes for feedback in one-dimensional distributed feedback lasers and two-dimensional photonic-crystal lasers1234. Although photonic band-edge lasers are widely used in optics and biological applications, drawbacks include low modulation speeds and diffraction-limited mode confinement56. In contrast, plasmonic nanolasers can support ultrafast dynamics and ultrasmall mode volumes789. However, because of the large momentum mismatch between their nanolocalized lasing fields and free-space light, they suffer from large radiative losses and lack beam directionality. Here, we report lasing action from band-edge lattice plasmons in arrays of plasmonic nanocavities in a homogeneous dielectric environment. We find that optically pumped, two-dimensional arrays of plasmonic Au or Ag nanoparticles surrounded by an organic gain medium show directional beam emission (divergence angle <1.5° and linewidth <1.3 nm) characteristic of lasing action in the far-field, and behave as arrays of nanoscale light sources in the near-field. Using a semi-quantum electromagnetic approach to simulate the active optical responses, we show that lasing is achieved through stimulated energy transfer from the gain to the band-edge lattice plasmons in the deep subwavelength vicinity of the individual nanoparticles. Using femtosecond-transient absorption spectroscopy, we verified that lattice plasmons in plasmonic nanoparticle arrays could reach a 200-fold enhancement of the spontaneous emission rate of the dye because of their large local density of optical states.

Source: http://www.nature.com

 

is a �x o �&� �t� mprove the delivery rate, Anderson says.

“We believe that these particles can be made more efficient. They’re already very efficient, to the point where micrograms of drug per kilogram of animal can work, but these types of studies give us clues as to how to improve performance,” Anderson says.

Molecular traffic jam

The researchers found that once cells absorb the lipid-RNA nanoparticles, they are broken down within about an hour and excreted from the cells.

They also identified a protein called Niemann Pick type C1 (NPC1) as one of the major factors in the nanoparticle-recycling process. Without this protein, the particles could not be excreted from the cells, giving the siRNA more time to reach its targets. “In the absence of the NPC1, there’s a traffic jam, and siRNA gets more time to escape from that traffic jam because there is a backlog,” says Gaurav Sahay, an MIT postdoc and lead author of the Nature Biotechnology paper.

In studies of cells grown in the lab without NPC1, the researchers found that the level of gene silencing achieved with RNA interference was 10 to 15 times greater than that in normal cells.

Lack of NPC1 also causes a rare lysosomal storage disorder that is usually fatal in childhood. The findings suggest that patients with this disorder might benefit greatly from potential RNA interference therapy delivered by this type of nanoparticle, the researchers say. They are now planning to study the effects of knocking out the NPC1 gene on siRNA delivery in animals, with an eye toward testing possible siRNA treatments for the disorder.

The researchers are also looking for other factors involved in nanoparticle recycling that could make good targets for possibly slowing down or blocking the recycling process, which they believe could help make RNA interference drugs much more potent. Possible ways to do that could include giving a drug that interferes with nanoparticle recycling, or creating nanoparticle materials that can more effectively evade the recycling process.

“This paper describes a new and very important way to improve the potency of siRNA delivery systems by inhibiting proteins that recycle imported material back out of the cell,” says Pieter Cullis, a professor of biochemistry and molecular biology at the University of British Columbia who was not part of the research team. “It is possible that this approach will give rise to the order-of-magnitude improvements in potency required for siRNA-based therapeutics to be more generally effective agents to treat disease.”

The research was funded by Alnylam Pharmaceuticals and the National Heart, Lung, and Blood Institute.

 

Source: http://web.mit.edu

 

Z�htX1� @�� elial-mesenchymal transition — a process that allows cancer cells to lose their adhesion and become mobile, helping them metastasize.

Other authors of the paper are MIT postdoc Sungmin Son; Stanford University postdoc Dario Amodei; MIT grad students Nathan Cermak, Joon Ho Kang and Vivian Hecht; former MIT postdoc Monte Winslow; Tyler Jacks, the David H. Koch Professor of Biology at MIT and director of the Koch Institute; and Parag Mallick, an assistant professor of radiology at Stanford.

The research was funded by the National Cancer Institute, through MIT’s Physical Sciences Oncology Center and Stanford’s Center for Cancer Nanotechnology Excellence and Translation, and Stand Up to Cancer.

 

Source: http://web.mit.edu

 

Revised Guidelines: Secondary Prevention and Risk Reduction in Patients with Atherosclerotic Disease.


New recommendations for cardiac rehabilitation and risk reduction are welcome, but updated guidance is lacking on lipid and blood pressure management.

Sponsoring Organizations: American Heart Association, American College of Cardiology

Background and Purpose: This revision updates the 2006 secondary prevention guidelines (JW Cardiol Jun 8 2006) and incorporates risk reduction into their title and purview. The guidelines continue to focus on important patient behaviors, including 30 minutes of physical activity daily, smoking cessation and avoidance of secondhand smoke, and weight management. However, the writing committee has deferred making major changes to the 2006 recommendations on blood pressure control and lipid management pending the revised versions of the National Heart, Lung, and Blood Institute‘s Joint National Committee guidelines (JNC) and Adult Treatment Panel report (ATP), respectively (both expected in 2012).

Key Points:
1. A new section of Class I and Class IIa recommendations highlights the importance of referring patients for cardiac rehabilitation.

2. The guideline authors have reorganized the section on lipid management to emphasize evidence-based use of statins rather than the achievement of target lipid levels. Although no new specific recommendations have been added, the lack of evidence supporting non-statin lipid-lowering agents has demoted the use of combined drug therapies from Class I to either Class IIa or IIb, depending on the agent.

3. The authors have updated recommendations regarding antiplatelet therapy, incorporating new data on prasugrel from TRITON TIMI 38 and ticagrelor from PLATO (Class I).

4. The recommendations for beta-blocker therapy have been expanded and clarified, reflecting evidence that the drugs are most efficacious in patients with recent myocardial infarction, left ventricular systolic dysfunction, or both.

5. The guidelines now identify and direct specific recommendations to populations at very high risk for poor outcomes.

6. A new section of Class IIa and Class IIb recommendations addresses screening for and management of depression.

Comment: The shift in focus toward risk reduction will help clinicians improve care for many patients, including older adults and those with depression. Although the guidelines are extensive and well written, the lack of new recommendations regarding the management of hyperlipidemia and hypertension decreases their immediate value. Virtually all patients with atherosclerotic disease have one or both of these conditions, and it is unfortunate that we must await the eighth edition of JNC and the fourth edition of ATP to inform current, evidence-based management decisions.

Source:Journal Watch Cardiology