Indian Medicine

LONDON (Reuters) - Researchers have pinpointed two common bacteria that may contribute to crib deaths, even when infants show no sign of tissue damage.

Post-mortem tests on more than 500 babies found high levels of Staphylococcus aureus and Escherichia coli in babies who died for unexplained reasons, a team from Great Ormond Street Hospital for Children in London said on Friday.

One explanation could be that the bacteria release deadly toxins, which damage the young heart, lungs or nervous system.

But bacterial growth may also be a secondary effect of other known risk factors like over-heating, parental smoking and lying a child on its stomach.

Sudden unexpected death in infancy (SUDI) is a leading cause of death in babies under a year old, yet its root cause remains a mystery. Healthy looking infants can often die in less than an hour.

The latest findings in the Lancet medical journal suggest underlying infection could be an important component.

"You've got to be very careful how you interpret this data," Nigel Klein, one of the researchers, said in an interview. "But we did find an increased number of bacteria grown from particularly the lungs and spleen in infants who died unexpectedly without a known cause."

Cases of S. aureus and E. coli were significantly more frequent in the group of babies whose death could not be explained than in those who died of non-infective explained causes, such as congenital abnormalities.

Both S. aureus and E. coli are classed as "group 2 pathogens", which are known to cause septicaemia without obvious damage to tissues in the body.

Alan Craft, professor of child health at the University of Newcastle, said the findings were important but there might not be a simple answer.

"The bacteria found are ones which are in all of our bodies most of the time and there is nothing that can be done to avoid them," Craft said.

Copyright © 2008 Reuters Limited.

LONDON (Reuters) - A Mediterranean diet rich in fruits and vegetables -- already known to protect against heart disease -- also appears to help ward off diabetes, Spanish researchers said on Friday.

The study published in the British Medical Journal showed that people who stuck closely to the diet were 83 percent less likely to develop type 2 diabetes than those who did not.

"The new thing is that we have been able to assess adherence to a Med diet and the incidence of diabetes in people who were initially healthy," said Miguel Martinez-Gonzalez, an epidemiologist at the University of Navarra in Spain, who led the study. "We didn't expect such a high reduction."

The World Health Organisation estimates more than 180 million people worldwide have diabetes -- a number likely to more than double by 2030 as more nations adopt a Western lifestyle.

Type 2 diabetes accounts for 90 percent of all cases and is closely linked to obesity and heart disease. The condition accounts for an estimated 6 percent of all global deaths.

For their study the Spanish researchers recruited 13,000 former students at the university with an average age of 38 who had no history of diabetes. They tracked their dietary habits and health over an average four years.

The volunteers also initially completed a food frequency questionnaire to measure the kinds of food they ate. The list included questions on the use of fats and oils, cooking methods and dietary supplements.

People who strictly adhered to a Mediterranean diet full of vegetables, fish and healthy fats such as olive oil, and low in red meat, dairy products and alcohol had lower odds of diabetes.

Only about 40 people in the study developed diabetes but Martinez-Gonzalez added in a telephone interview that further study is needed to confirm the diet's protective effects.

But the fact that the protection appeared to extend to older people, smokers and volunteers with a family history of diabetes -- a group all the more prone to the disease -- shows the diet works, Martinez-Gonzalez said in a telephone interview.

"These higher risk participants with better adherence to the diet, however, had a lower risk of diabetes, suggesting that the diet might have a substantial potential for prevention," the researchers wrote.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - People with type 1 diabetes who need a kidney transplant, as many do, fare better over the long term when they receive a pancreas transplant at the same time, according to researchers from the University of Heidelberg in Germany.

"Our study shows that a functioning pancreas has a benefit for the simultaneously transplanted kidney," lead investigator Dr. Christian Morath said in a statement. "At the same time, this procedure prolongs the survival of the patient, compared to a patient who received only a kidney transplant."

The reason for the improved survival with simultaneous pancreas-and-kidney transplantation is not fully known, but likely relates to the enhanced glucose control achieved with the combined procedure, the researchers note in the Journal of the American Society of Nephrology.

The study involved 2190 patients given a living-donor kidney, 5705 deceased-donor kidney recipients, and 3525 patients undergoing simultaneous pancreas-and-kidney transplantation.

Compared with the other groups, the deceased-donor kidney group had inferior survival rates, the report indicates, a finding that is consistent with prior research.

Initially, the pancreas-and-kidney group had worse survival than did the living-donor kidney group, but the pancreas-and-kidney group's rate eventually caught up, and beyond 10 years survival was higher.

In fact, after 10 years, the risk of dying for pancreas-and-kidney recipients was 45 percent lower than for living-donor kidney patients.

"Based on these results, we feel that all type 1 diabetics with kidney failure should be considered for simultaneous pancreas-kidney transplantation," Dr. Morath concluded.

SOURCE: Journal of the American Society of Nephrology, online May 21, 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - A new analysis of current research provides "the strongest evidence to date" that giving small children supplemental vitamin D will help prevent them from developing type 1 diabetes later on, according to the review's co-author.

"This is just another reason why current recommendations regarding vitamin D supplementation should be rigorously adhered to," Dr. Christos S. Zipitis told Reuters Health.

Vitamin D is produced in the skin with sun exposure. Deficiency in the nutrient can lead to a host of health problems, Zipitis said. Because breast milk typically contains little vitamin D, the American Academy of Pediatrics recommends vitamin D supplements for nursing infants and UK public health authorities say that all children should receive the supplements for at least the first two years of life.

There are a number of clues suggesting a link between low vitamin D levels and type 1 diabetes, Zipitis of Stockport National Health Service Foundation Trust and Dr. A. K. Akobeng of Booth Hall Children's Hospital in Manchester, UK, note in their report in the Archives of Disease in Childhood.

The investigators reviewed all published research on vitamin D supplementation and diabetes risk. Overall, they found, infants who were supplemented with Vitamin D were 29 percent less likely to develop type 1 diabetes than children who had not received supplements.

Proper clinical trials are required to determine the optimal dose and formulation of vitamin D, as well as when and for how long children should be given the supplements, Zipitis and Akobeng conclude.

In the meantime, Zipitis said, "I would advise parents to encourage their pediatricians to prescribe vitamin D supplements for their infants. However, parents can also obtain these over the counter and provided they are used as per manufacturer instructions they should be extremely safe to use."

SOURCE: Archives of Disease in Childhood, June 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - During the 6-month period following a stroke, falls are common and often result in injury requiring medical treatment, according to surveys of more than 1000 stroke survivors in New Zealand.

Once stroke patients leave the hospital, their risk of falling is double that of people who haven't had a stroke, Dr. Ngaire Kerse of the University of Auckland told Reuters Health.

"Fall prevention should be part of stroke rehabilitation," she stressed.

Kerse's team interviewed 1104 stroke survivors, average age 71 years. According to their report in the American Heart Association's journal Stroke, 407 patients (37 percent) reported having a fall in the 6 months since their stroke. Most falls occurred at home and indoors.

Among those who had fallen, more than one-third suffered an injury that required medical treatment, and 8 percent sustained a fracture.

"Our findings highlight the need for fall prevention interventions," Kerse continued. "For all older people, proven strategies involve mobility retraining (already a part of stroke rehab) and occupational therapy assessment and modification of hazard risk at home," such as ensuring appropriate lighting, removal of obstacles and installation of transfer rails.

Still, little is known regarding strategies that would be most beneficial to stroke patients. To bridge that gap, Kerse and her associates are planning a fall-prevention trial for stroke survivors living in the community.

SOURCE: Stroke, June 2008.

Copyright © 2008 Reuters Limited.