'Heart attack breakthrough' - Research

Scientists have discovered a way to stimulate muscle cell growth in the heart, limiting the damage to this vital organ after a heart attack

Scientists have now found a new way to potentially regenerate the heart after a heart attack by replacing lost muscle cells. According to Professor Richard Harvey from the Victor Chang Cardiac Research Institute, this is an important step forward toward repairing a broken heart.

“Unlike blood, hair or skin cells, which can renew themselves throughout life, cell division in the heart virtually comes to a standstill shortly after birth, which means the heart can’t fully regenerate if it is damaged later in life,” Professor Harvey explained.

“Previous studies have demonstrated that it is possible to coax heart muscle cells to proliferate again, but only at very trivial levels.

“What the research team has been able to do is boost heart muscle cell numbers by as much as 45% after a heart attack. That’s a huge improvement!”

Scientists focused on a signalling system in the heart driven by a hormone called ‘neuregulin’.

By switching the neuregulin pathway to ‘turbo charge’ the researchers found that heart muscle cells continued to divide in a spectacular way in both the adolescent and adult periods.

Stimulating the neuregulin pathway during a heart attack lead to replacement of lost muscle.

The study has been published in Nature Cell Biology. To read more click here

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€30 Million SFI Investment in Scientific Research

Dr Laoise McNamara's project on osteoporosis was one of three NUI Galway projects funded.

Minister for Skills, Research and Innovation, Damien English TD today announced over €30 million of research funding for 23 major research projects. The Programme will provide funding over a four to five year period, for 23 research projects involving over 100 researchers. Funding for each project will range from €500,000 to €2.3 million.

Three of the projects are led by NUI Galway researchers, and in partnership with University of Limerick, are significantly involved in a fourth project. 

Two of the projects are listed below:

Dr Laoise McNamara, NUI Galway - This research project will advance understanding of mechanobiology to develop treatment approaches for bone pathologies. Tissues of the human body can adapt in response to mechanical forces by a cellular process known as mechanobiology. Although mechanobiological processes are fundamental to normal bone physiology and may play an important role in the development of osteoporosis, the role of mechanobiology in bone development and changes occurring during ageing are not yet fully understood. Moreover mechanobiological responses have not been targeted as treatments for osteoporosis, nor have they been sufficiently exploited to develop novel regenerative tissue strategies.

Dr Alan Ryder, NUI Galway - Many drugs for human health are complex biological molecules like proteins which are made in living cells on an industrial scale. Both the cell food (media) and the protein products have to be carefully analysed to make sure that they are good and safe. Both media and proteins are very complex mixtures that are difficult to analyse. Here we will build a faster, cheaper, and non-contact way of testing using light to generate chemical information from these mixtures. This information will then be analysed using advanced statistical methods (chemometrics) and the results used to improve manufacturing, and reduce drug costs.

View more information on NUIG website

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New Ebola drug clears virus from monkeys - results published in 'Nature'

More than 26,000 people have been infected with Ebola since the outbreak began

An experimental Ebola drug cured three monkeys intentionally infected with the virus, according to a study published in Nature magazine.

The development marks the first such success against the strain of Ebola that killed up to 10,000 people in West Africa’s 2014-2015 outbreak.

Although other experimental treatments appeared to help Ebola patients last year, especially in the United States, those one-time uses cannot prove efficacy against the “Makona” strain, since patients’ recovery might be due to other causes.

Similarly, drugs, including Mapp Biopharmaceutical’s ZMapp, cured monkeys in lab experiments, but in a strain of Ebola different from that responsible for the current outbreak, the worst ever recorded.

“We can’t say for certain that an experimental drug that works against one strain will work in another, even if they’re almost identical genetically,” said Thomas Geisbert of the University of Texas Medical Branch, senior author of the study published in the journal Nature.

In the experiment, six rhesus monkeys were infected with huge doses of the Makona strain. Three days later, three received an infusion of a drug developed by Tekmira Pharmaceuticals Corp, a cocktail of “small-interfering RNAs” (siRNAs) encapsulated in a fat droplet called a lipid nanoparticle.

The siRNAs bind to two of the virus’s seven genes, silencing them and thereby preventing the virus from replicating.

All three treated monkeys survived despite fevers and enormous blood levels of virus. 

The drug can be adapted to target any strain of Ebola and produced in as little as eight weeks (compared with the months required for ZMapp), Geisbert said, in what he called “plug and play”: sequence any Ebola genome and custom-make a siRNA cocktail.

“There is a need for treatments that can be quickly modified if the strain changes,” he said.

A clinical trial of the new cocktail began last month in Ebola patients in Sierra Leone. A study of an earlier version was partly halted after healthy volunteers developed side effects at high doses. 

Results from human trials with the drug are expected in the second half of this year.

Read more on Irish Times/ Health here

Writing competition for International Clinical Trials Day

Want to win an iPad Air and get your story in the Irish Times? The HRB Trials Methodology Research Network (HRB-TMRN) is running a national writing competition to mark this year's International Clinical Trials Day which takes place on 20 May.

This competition is open to everyone wishing to provide a perspective on clinical trial research, including patients, clinicians, researchers, academia and industry.

It must be written for a general audience and no more that 800 words in length.

• The deadline for submission is Wednesday 6 May 5.00pm.
• Entries should be sent to hrb-tmrn@nuigalway.ie with 'IT COMPETITION' in the subject line.

The winning entry will appear in the Irish Times Health and Family Supplement on 19 May 2015 (subject to editorial approval).

Full competition details are available from the HRB-TMRN website 

Ireland has ‘fastest rising need’ for palliative care in Europe

Rapidly-ageing Irish population behind trend, new study suggests

Ireland has the fastest rising need for palliative care in Europe due to its rapidly ageing population, a new study suggests.

Significant increases in funding will be needed to cater for the increase in deaths from cancer, dementia and neurodegenerative diseases such as Alzheimer’s, according to the study published by British and Irish researchers in the Journal of Pain and Symptom Management.

Eighty per cent of the deaths recorded between 2007 and 2011 were from conditions recognised as having associated palliative care needs. This compares to 63 per cent in the UK and 50 per cent in Australia.

The study shows that while deaths from cancer increased by 9.5 per cent over this period, the increase in deaths caused by dementia and neurodegenerative diseases was far greater, as 51 per cent and 43 per cent respectively. In contrast, deaths from heart and respiratory disease, and stroke, are falling.

It says new models of palliative care may be required to address these trends. Current funding levels are running at only half the required amount.  

“It is internationally recognised that the prevalence of advanced chronic conditions such as cancer, dementia and neurodegenerative disease, which have recognised palliative care needs, increases with older age,” said lead author Dr Pauline Kane of King’s College London. “With Ireland’s population ageing at the fastest rate in Europe, this palliative care need will continue to grow.

View more here

Lancet study: 'Mindfulness option for depression'

A mindfulness-based therapy could offer a "new choice for millions of people" with recurrent depression, a Lancet report suggests. 

Scientists tested it against anti-depressant pills for people at risk of relapse and found it worked just as well.  The therapy trains people to focus their minds and understand that negative thoughts may come and go.

In England and Wales doctors are already encouraged to offer it.

Patients who have had recurrent clinical depression are often prescribed long-term anti-depressant drugs to help prevent further episodes.

In this study, UK scientists enrolled 212 people who were at risk of further depression on a course of mindfulness-based cognitive therapy (MBCT) while carefully reducing their medication.

Patients took part in group sessions where they learned guided meditation and mindfulness skills.

The therapy aimed to help people focus on the present, recognise any early warning signs of depression and respond to them in ways that did not trigger further reoccurrences.

Researchers compared these results to 212 people who continued to take a full course of medication over two years.

By the end of the study, a similar proportion of people had relapsed in both groups. And many in the MBCT group had been tapered off their medication.

Scientists say these findings suggest MBCT could provide a much-needed alternative for people who cannot or do not wish to take long-term drugs.

Providing an independent comment on the study, Dr Gwen Adshead, of the Royal College of Psychiatrists, said: "These findings are important from the point of view of people living with depression who are trying to engage in their own recovery."

"And it provides evidence that MBCT is an intervention that primary care physicians should take seriously as an option."

But he cautioned the research does not suggest MBCT is useful for all types of depression; nor that it should replace anti-depressant treatment for people with severe disorders who have needed hospital treatment or are suicidal.

And experts caution patients should only reduce their anti-depressant medication under medical supervision.

Researchers say their next step is to tease out what the active ingredient in mindfulness therapy might be, and to check it compares favourably to other group-based approaches.

View article in Lancet: 

View more on The Guardian here

Anxiety tops concerns for teenagers contacting Jigsaw

Anxiety is the most common concern raised by young people seeking help with mental health issues, a new study indicates.

Low mood, anger, family problems and stress were the other main issues raised by over 10,000 young people attending the Jigsaw mental health service between 2009 and 2015.

The analysis of attendance figures for 2013 shows there are significant differences in the issues of concern between boys and girls and between young people of different ages.

For young women, anxiety, family problems and isolation issues emerged as the main concerns, according to the study published in the Irish Journal of Psychological Medicine.

For boys, the main issues were anxiety, anger and family problems.

Girls are more likely to experience anxiety, thoughts of hurting themselves, low self-esteem and feelings of sadness or loss. Boys were more likely to present with anger and drug use.

Headstrong,the national centre for youth mental health, set up Jigsaw in response to the need for supports for young people.

The service provides free mental health supports for young people aged 15-25 years in 10 communities around the State.

Almost one-third of young people referred themselves to the service, while 27 per cent of referrals came from parents and 12 per cent from a GP.

Study finds 24,000 could have undiagnosed Type 2 diabetes

The largest ever study into diabetes and cardiovascular risk in Ireland has found as many as 24,000 people could have undiagnosed diabetes.

The survey by Vhi Healthcare examined 30,000 people between 2009 and 2013.

It found that 17% of people were found to have abnormal initial fasting blood sugar levels.

Men were found to be two to three times more likely than women to have abnormal blood sugar levels and undiagnosed diabetes.

Report author and Vhi Healthcare Medical Director Dr Bernadette Carr said: "The results of our research suggest that the rate of undiagnosed type 2 diabetes and pre-diabetes is higher in Ireland than in similar European countries such as Britain and Holland.

"They also demonstrate how important it is for individuals to understand and manage their own health risks.  

"By making some very simple lifestyle changes, people can improve their outcomes, and in the case of pre-diabetes can even delay or prevent progression to diabetes."

The research found that people with abnormal blood sugar levels were significantly more likely to be older, male, smokers and have higher blood pressure.

It said they were also less likely to exercise five days a week or eat fruit or vegetables each day.

View on RTE/Health

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Schools study shows fitness level stalls in teenage girls

The fitness level of Irish girls stalls in their early teenage years, with the average 16-year-old performing no better in tests than a 12-year-old, the results of a countrywide schools-based challenge show.

Boys’ fitness improves over the same age period, with 16-year-olds on average 33 per cent fitter than 12-year-olds, according to the challenge taken by 148 schools.

“The fact that girls are not showing the same improvement in cardiovascular fitness as boys is clearly a cause for concern,” said Prof Niall Moyna of DCU’s school of health and human performance, who set up the challenge four years ago.

Related research into children with low levels of fitness has found evidence of heart disease in the arteries of 15-year-olds, he said. The same children were also found to have high cholesterol, blood pressure and fat levels.

Both boys and girls improved their performance after undertaking a six-week fitness programme that forms part of the challenge, which was taken by more than 10,000 children this year.

The average improvement for boys was 12 per cent while for girls, coming from a lower base, it was 19 per cent.

Prof Moyna says a variety of social and cultural reasons may explain young girls’ poor fitness levels.

“There are issues around the continuing participation of girls in sport as they grow older. They may become unused to pushing themselves, to being out of breath, even to the fact their make-up could run.”

However, he is optimistic about the future because of a “paradigm shift” in recent years which has made it more acceptable for girls to continue in sport, as well as an increase in team sport options.

While Irish boys and girls are well above the European average for fitness for their age group, this is not regarded as an accurate guide to the minimum fitness level required for optimal health, according to Prof Moyna.

The European figures are a “race to the bottom” in terms of performance and Ireland should develop its own national norms, he maintains.

“Lifestyle behaviours tend to track from childhood to adulthood. Children who are unfit and overweight in their teenage years will likely be unfit and overweight as adults.”

Taoiseach Enda Kenny will today present prizes to the most improved schools in the challenge, which is sponsored by Aviva Health.  : The Schools' Fitness Challenge

View more on Irish Times/Health here

Breath test 'could give clues to stomach cancer risk'

A simple breath test could help predict whether people with gut problems are at high risk of developing stomach cancer, an early study shows.

It detects chemical compounds in people's breath, in an attempt to distinguish unique "breath prints" in those with risky pre-cancerous changes.

Experts say if proven in large trials, it could spot patients on the brink of cancer so they can be treated earlier.

But more work is needed to validate the test, which appears in the journal Gut.

In most Western countries stomach cancer is diagnosed late when the chance of survival is poor. This is partly because symptoms - such as indigestion and pain - can be mistaken for other diseases.

Scientists believe earlier detection may help improve the prognosis.

The new "nanoarray" breath test builds on earlier work from researchers in Israel, Latvia and China.

It relies on the idea that people with cancer may have unique breath signatures - containing minute chemical compounds that are not found in the breath of people free from the illness.

Researchers studied breath samples from 145 patients. Around 30 of these were already known to have stomach cancer.

The rest had been referred for investigations because of concerning symptoms. They did not have full-blown cancer - but some had worrying changes that doctors call "pre-cancerous" that could develop into malignancies.

View full report on BBC/Health 

INMO survey finds rise in bullying of nurses and midwives

A large-scale survey of more than 2,000 nurses and midwives in Ireland suggests 6% of respondents are being bullied on a daily basis.

The last survey on the incidence of workplace among nurses and midwives was carried out in 2010 and according to this latest study the problem has worsened significantly since then.

The survey of 2,400 members of the Irish Nurses and Midwives Organisation found that almost 6% of respondents reported being bullied on an almost daily basis. 

View results of survey here

Of that 6%, non-union members were almost twice as likely to experience bullying.

Furthermore there had been an increase of over 13% in the perceived incidences of bullying since 2010.

The INMO has claimed that Government cutbacks are the most probable explanation and is seeking an early engagement with employers on the issue.

The organisation has also accused the Health Service Executive and private sector employers of not taking reports of bullying seriously enough.

Speaking on RTÉ's Morning Ireland, Director of Industrial Relations at the INMO Phil O'Shea said the survey found Government cutbacks had increased the incident of workplace bullying among nurses and midwives.

Ms O'Shea said employers need to take the issue more seriously.

Ms O'Shea went on to say that by the time reports of bullying reach the stage of formal investigation many of these workplace relationships have broken down irretrievably.

The INMO will outline the results of the Survey today at INMO Buildings
View more here

‘Off switch’ identified to cut spread of bowel cancer

Dr Aideen Ryan from NUI Galway found that switching off a specific protein in bowel cancer cells can stimulate an anti-tumour immune response.

The research that opens new avenues for the development of novel treatment approaches was funded by the Irish Cancer Society.

Bowel cancer is a significant health concern in Ireland with 2,400 new cases diagnosed and almost 1,000 deaths from the disease every year.

Up to now, therapeutic developments to stop its spread to other parts of the body have had very little success.

Dr Ryan found the activity of a key protein known as NF-kappaB, with the help of a type of immune cell, called tumour-associated macrophages (TAMs), promotes the spread of cancer cells from the bowel to the abdominal cavity.

TAMs are present within or close to tumour tissue and can act in tumour-promoting or a tumour-killing manner, depending on their surrounding environment.

Dr Ryan and colleagues in NUI Galway found TAMs can be switched from being tumour-promoting to being tumour-killing by turning off the NF-kappaB protein in bowel cancer cells, thereby causing a significant reduction in bowel cancer spread to the abdominal cavity.

Dr Ryan said the findings had, for the first time, uncovered the effect of targeting the NF-kappaB protein in bowel cancer cells.

“We are continuing this important research in order to develop a new treatment approach for bowel cancer which could potentially result in better treatments for patients with this disease,” she said.

Read more on Irish Examiner here

Study on Alcohol and Pregnancy

Pregnant women have been warned that even half a glass of wine can cause a foetus to stop breathing and moving for as long as two hours

Professor Peter Hepper of Queen's University in Belfast examined the effects of low-level alcohol exposure during pregnancy by using 18-week scans on women who drank an average of a glass of wine a week.

He found that during the scans, the foetuses stopped breathing and moving, sometimes for up to two hours.

They could suddenly jump and turn themselves over. These jolts suggested that their brains were not developing properly.

His advice is that the "only safe level of alcohol is zero" for pregnant women. This ties in with the advice of the Department of Health.

He said the foetus should be continually active.

It is already accepted that drinking heavily throughout pregnancy can cause a baby to develop a serious condition called foetal alcohol syndrome (FAS).

Children with FAS have restricted growth, facial abnormalities and learning and behavioural disorders.

Drinking alcohol is potentially most harmful for a foetus in the first three months of pregnancy, when it is linked to miscarriage and to birth abnormalities.

Irish women with higher levels of income and education are more likely to drink alcohol weekly during their pregnancy, a Growing Up in Ireland study found.  "Some groups of women drink lower levels continuously while other women binge drink at weekends and don't drink during the week," he said.

"Binge drinking is potentially more harmful because there is  more exposure to alcohol but I don't think there's any evidence to suggest that if you drink lower amounts of alcohol more regularly, it's any less harmful or somehow more safe."

View more information here Foetal Behaviour Research Centre

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Office workers 'Too Sedentary'

Office workers need to get up and move around more, according to a new campaign in the UK - 'On Your Feet Britain'.

It says sitting for long periods at work is linked to a host of health problems, which are not undone by working out in the gym.  It is calling on people to stand regularly, walk around more and embrace ideas such as standing meetings or standing desks.

Experts described inactivity as "one of the biggest" challenges in health.

Heart disease, type 2 diabetes, cancers and poor mental health have all been linked to sedentary behaviour.

View Study here: Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults: A Systematic Review and Meta-analysisSedentary Time and Disease Incidence, Mortality, and Hospitalization

The effect is found even in people who class themselves as fit, such as those who cycle to work, if they also spend long periods of time sitting.

Prolonged sitting is thought to slow the metabolism and affect the way the body controls sugar levels, blood pressure and the breakdown of fat.

The campaign is a partnership between the group Get Britain Standing and the British Heart Foundation (BHF) charity.

Their survey of 2,000 office workers suggested:

• 45% of women and 37% of men spend less than 30 minutes a day up on their feet at work
• More than half regularly eat their lunch at their desk
• 78% office workers felt they spent too much time sitting down
• Nearly two-thirds were worried sitting at work was having a negative impact on their health

View more on BBC/Health here

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Children's Diets Are Raising Their Risk of Heart Disease

The rate of childhood obesity has been rising – and their risk of heart disease later in life along with it. The problem might be worse than we realize. A new study concluded that between 2003 and 2010, over 80% of children in the U.S. had a poor diet.

According to the team from NHS Behind the Headlines, the large survey behind these figures should be nationally representative. Called NHANES, the National Health and Nutrition Examination Survey is run by the Centers for Disease Control and Prevention (CDC).

The Behind the Headlines point out that the results can’t be exact. They point to reasons such as the survey being based on people’s memories of what was consumed – and the ideal dietary intakes weren’t based on the individual children’s age and other key characteristics. You can read more about it in PubMed Health’s Behind the Headlines feature.

How could this trend be turned around? Check out these systematic reviews at PubMed Health:

• Getting under 5s to eat more fruits and vegetables (fruit was easier!)
• Obesity prevention programs to support parents and schools to encourage healthier diets and physical activity in children
• School programs for physical activity and fitness in children and teenagers

New Nursing Code of Conduct launched in UK

The Nursing and Midwifery Council (NMC) has today published a revised Code which places public expectations at the heart of good nursing and midwifery practice.

From today, every nurse and midwife in the UK will practice in line with a revised  Code from their regulator, the Nursing and Midwifery Council (NMC).

Jackie Smith, NMC Chief Executive and Registrar, said: “This is a landmark day for every nurse and midwife in the UK, and for the people they care for.

“The Code  is fundamental to protecting the public. It sets out what patients want from nurses and midwives, and puts public expectations at the centre of professional practice.

View here

“We last changed the Code seven years ago. Since then, the way that care is delivered has changed; public expectations have changed; and key reports like the Francis Inquiry have permanently altered the healthcare landscape. The revised Code reflects modern needs.”

The Code is central to revalidation, which the NMC is launching in October 2015 to check that nurses and midwives are up to date and fit to practise throughout their careers.

In addition to the Code, the NMC has also updated its guidance for nurses and midwives on raising concerns and has issued new guidance on the responsible use of social media.

View more on BBC/Health