Vodcast 2007 Show Notes

Episode #0007 — November 9, 2007
Time: 00:28:58 | Size: 226 MB

Welcome to i on NIH!

This episode is packed with new, timely stories. We have interviews about World AIDS Day; information on World Diabetes Day; a feature about a study involving twins, and an eye-to-eye interview about Chronic Obstructive Pulmonary Disease (COPD).

NARRATOR: 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 ANOTHER EPISODE OF EYE ON NIH! THIS EPISODE IS PACKED WITH NEW, TIMELY STORIES. WE HAVE INTERVIEWS ABOUT WORLD AIDS DAY; INFORMATION ON WORLD DIABETES DAY; A FEATURE ABOUT A STUDY INVOLVING TWINS, AND AN EYE-TO-EYE INTERVIEW ABOUT CHRONIC PULMONARY OBSTRUCTIVE DISEASE.
BUT FIRST, HERE’S HARRISON WEIN FROM THE NIH NEWS-DESK WITH A QUICK NEWS UPDATE. HARRISON?

HARRISON: THANKS, JOE. In this NIH Research Update, A Low-Fat Diet May Cut Ovarian Cancer Risk, the genetic secrets of an intestinal parasite revealed, and treatments for adolescent depression.

* Ovarian cancer is a very deadly form of cancer. It affects about one in sixty American women and kills about 15-thousand each year. Researchers have been examining the impact of dietary fat on ovarian and endometrial cancer in a group of almost fifty thousand healthy, postmenopausal women. these women were followed for an average of 8 years. this is part of the Women's Health Initiative series of studies. THE STUDY FOUND THAT Sticking to a low-fat diet for at least 4 years can reduce an older woman's risk of developing ovarian cancer by about 40%. These new findings support the idea that some women may be able to reduce cancer risks by lowering the amount of fat in their diet.*

* Giardia is responsible for more than 20-THOUSAND reported infections a year in the U.S. Many people with Giardia infections never even know they have it, and the infection resolves on its own. About half of those infected, however, develop severe nausea, diarrhea, bloating and abdominal cramping. An international team of researchers, funded by NIH, has now sequenced all the genetic material-the genome-of the parasite. they found that It has a large number of unusual proteins that are potential targets for new drugs or vaccines *

* By some estimates, about FIVE-PERCENT of adolescents suffer with major depression. A new NIH-funded study has found that the best treatment for depressed teens may be a combination of talk therapy and medicine. After 18 weeks, 85% of teens taking the combination treatment got better. less than 70% of those taking only the drug or talk therapy improved. Even after 36 weeks, combination therapy continued to help more teens than the other approaches. The study included a mix of younger and older teens, from different ethnic and racial groups and a range of social and economic backgrounds. because of this, the researchers argue, their results should apply to the adolescent population overall.*

*We cover tHESE AND OTHER NIH RESEARCH studies in "NIH RESEARCH MATTERS". GO TO WWW-DOT-NIH-DOT-GOV. LOOK FOR THE LINK ON THE RIGHT-HAND SIDE, UNDER "IN THE NEWS," THAT SAYS, "E-COLUMN: NIH RESEARCH MATTERS." *

* And IN THIS MONTH'S HEALTH NEWSLETTER, "NIH NEWS IN HEALTH"…
Indulge in rich foods over the holidays and you may wind up paying the price in extra pounds. Why not make this the year you reverse the trend and stop gaining weight over the holiday season? ALSO, The Vexing Pain of Vulvodynia. Read about what it is among other stories in "NIH NEWS IN HEALTH" AT NEWS-IN-HEALTH-DOT-NIH-DOT-GOV. *

THIS IS HARRISON WEIN AT THE NIH SCIENCE DESK. *

HOST: THANKS HARRISON. IN OTHER NEWS, WORLD AIDS DAY IS COMING UP. EYE-ON-NIH TALKED TO DR. VICTORIA CARGILL, DIRECTOR OF MINORITY RESEARCH AND CLINICAL STUDIES IN THE OFFICE OF AIDS RESEARCH ABOUT IT.

DR. CARGILL – WORLD AIDS DAY IS DECEMBER FIRST… IT STARTED IN 1988… A GLOBAL DAY… TO COMMEMORATE… HIV PREVENTION AND HIV MANAGEMENT.

HOST: WE ASKED DR. CARGILL, HOW EVERYONE CAN BE INVOLVED IN THE AIDS EFFORT…

DR. CARGILL – … AIDS IS EVERYONE’S BUSINESS. IT MAY BE VERY EASY TO SAY, WELL I DON’T KNOW ANYONE PERSONALLY THAT HAS AIDS… YES IT DOES. IT DOES TAKE OUR BEST AND BRIGHTEST… SO ONE OF THE THINGS I’VE OFTEN THOUGHT ABOUT IS WHAT IF EVERYONE OF US TALKS TO FOUR PEOPLE ABOUT AIDS… BECAUSE AIDS TARGETS THOSE THAT ARE WEAKEST… OR WHETHER WE’RE EMOTIONALLY VULNERABLE… DOESN’T MATTER. SO WHAT IF EACH ONE OF US TALKED TO FOUR PEOPLE… WE WOULDN’T HAVE TO HAVE ANY MORE WORLD AIDS DAYS.

HOST: WE ALSO ASKED, WHAT DR. CARGILL IS PLANNING FOR WORLD AIDS DAY…

DR. CARGILL – FOR ONE THING, I’M GOING TO BE SPEAKING… TALK TO A COMMUNITY… AND THEN THE OTHER THING… I’VE KEPT A MENTAL TALLY… AND THERE WAS A TIME I RODE… I TAKE A GOOD 5-6 MINUTES… GAVE THEM MY LEVEL BEST.

HOST: DR. CARGILL SAYS THERE IS A GREAT DEAL OF INFORMATION AVAILABLE ONLINE ABOUT WORLD AIDS DAY, NIH-DOT-GOV IS A GOOD PLACE TO START.

HOST: NEXT WE TURN TO ANOTHER TIMELY TOPIC – THIS MONTH IS WORLD DIABETES DAY, NOVEMBER 14. WALLY AKINSO AND BILL SCHMALFELDT HAVE PUT TOGETHER A DETAILED REPORT ON THE IMPORTANCE OF DIABETES AWARENESS, AND RESOURCES FOR THOSE AFFECTED BY THE DISEASE.

VO: More than 20 million adults in the United States are living with diabetes, which puts them at an increased risk for developing heart disease and stroke. Heart disease is the number 1 cause of death for people with diabetes. In fact, 2 out of 3 people with diabetes die from heart disease or stroke. Our own Bill Schmalfeldt had the opportunity to chat with Dr. Griffin Rodgers, Director of the National Institute of Diabetes and Digestive and Kidney Diseases, about the importance for diabetics to monitor their health.

Rodgers: It’s important to keep in mind that it’s not only important to regulate the blood sugar but also the blood pressure and the cholesterol as you’ve indicated and therefore it’s important in the campaign that we have out is for people with diabetes to know there ABCs.

Rodgers: The A stands for (Broll: graphic ABCs 00:48). The "A" stands for A1C, or hemoglobin A1C, which is a simple blood test to determine what the average blood sugar level is for the previous three months. The "B" stands for blood pressure and the "C" stands for cholesterol. In patients with diabetes, we like their A1C level to reach a target somewhere below 7. The blood pressure, of course, the target is known. But in people that have a concomitant diabetes we like their blood pressure values to be below 130/80. And then, finally, cholesterol. There's so-called "good cholesterol," there's "bad cholesterol". The "bad cholesterol" or the ldl, we like the target value for that ldl in patients with diabetes to be less than 100. When patients with diabetes go to their providers, we want them to ask them a few questions. "What are my ABC's?" "What should my goals for the ABC's be?" And "How can I help in reaching those targets that you've set?"

VO: Currently 20.8 million Americans now have diabetes which is up from 17 million in 2002. One-third of all Americans with diabetes do not know they have it. Dr. Rodgers presents factors on why diabetes is increasing in Americans.

Rodgers: There are a number of factors that have been associated with that increase. Number one, we know that the risk factors for diabetes are increasing age. And I think one major contributor to that is really the aging—the baby boomers in our populations getting older, which would increase that risk factor. A second major risk factor for diabetes is actually an increased propensity in certain racial and ethnic groups, and so I think a second factor contributing is really a change in the demographics of the United States that we're seeing today. Largely though, and no pun intended, a major contributor to that has been overweight—almost an epidemic of overweight and obesity that we're seeing in this country. But not only that, also the decrease in physical activity. So it’s really those three factors that are sort of coming together now that are contributing to this increase in the number of patients. And that's sort of the bad news. The good news, though, is that there are things that can be done to diminish your chances of going on to develop diabetes or, in fact—if you have it—to diminish the likelihood that you'll develop these complications that we spoke about.

V/O: Working out and eating healthy is a good way to manage diabetes. Dr. Rodgers said it’s good to get at least 30 to 60 minutes of physical activity. Dr. Rodgers wasn’t the only one chatting with Bill about the impact of diabetes. Dr. Francine Kaufman Chair Elect of the National Diabetes Education Program also sat with Bill to discuss the impact of type 2 diabetes around the world.

Rodgers: Well there are more and more people certainly adults developing diabetes across the globe this is not about the developed world as much anymore. This is occurring in the developing world as well. And we are really talking, in this case, about type 2 diabetes; having to do with genes and environments coming into collision. So I just finished actually going around world for a discovery health making a documentary. We went to India, Brazil, South Africa and there are more and more people who are overweight and developing type 2 diabetes there. And more and more children involved in addition.

VO: The Search study focuses on children and youth in the U.S. who have physician-diagnosed diabetes. The goal of the study is to provide more information and help researchers better understand and treat diabetes in children and youth. Dr. Kaufman discusses the study.

Dr: Kaufman: Well type 2 diabetes is still relatively rare among children and we have wonderful data in the United States from the Search trial. That really shows that the predominate form of diabetes for children under the age of 10 is almost exclusively type 1. But over that age, so 11 to 19, there are more and more teens developing type 2 diabetes particularly Native American, Hispanic and African American, and Asian American teenagers in this country. And we’re seeing maybe not an epidemic but certainly an increase, a significant increase we don’t know where this might top out. And we have to be aware that this is something new for children.

Dr. Kaufman: Well the Search Trial is…part of its almost ended looking at incidence and prevalent cases of diabetes in the country and looking at some other risk factors. So I think one of the most impressive things that come out of Search is the number of children with both type 1 and type 2 diabetes who are at risk for cardiovascular disease. So in the type 1 population about 14 percent of these children already have 2 or more cardiovascular disease risk factors. And then type 2 population it was 92 percent of them. So it’s not just diabetes, it’s looking at diabetes as a risk factor for cardiovascular disease and realizing that this begins in childhood.

Dr. Kaufman: Well the first thing….I get a lot of questions of how do I make my children eat better. And the first thing I would say is well <Bill: Tell them to> well no, you do it first. You make your house a healthy environment and an option, particularly if you do it early enough. That will become their habit, that will become what they're used to and it will become, hopefully, what they want to do. You can't have your children do something you're not doing, so parents have to mirror good eating as well as good physical activity.

VO: The National Diabetes Education Program supplies a lot of information about diabetes which Dr. Kaufman talks about.

Dr. Kaufman: Well, the National Diabetes Education Program has put forward kind of a tip sheet of questions to ask at the time of diagnosis. I will tell you as a clinician, once your two year old or three year old is diagnosed with diabetes, a lot of these parents are just so overwhelmed and so emotional that it takes them awhile to wade through "what do I really need to find out?" This tip sheet will enable them to know, I know this has been a tremendous shock to me, my family and my child, but in addition, these are critical things I need to find out between me and my health care provider.

VO: For more information about the National Diabetes Education Program, visit www.YourDiabetesInfo.org or call 1-888-693-6337. This is Wally Akinso signing off from “I on NIH.”

HOST: THANKS WALLY. NOW SAY YOU’RE WATCHING THIS PROGRAM – OR MAYBE LISTENING TO IT ON A MEDIA PLAYER – AND THE PHONE RINGS. CAN YOU KEEP THE PROGRAM RUNNING AND PAY ATTENTION TO BOTH? FRANCES SANCHEZ REPORTS THAT GENETICS PLAY A FACTOR IN THIS KIND OF SELECTIVE HEARING.

VO: A study done in twins by the National Institute on Deafness and other Communication Disorders gave researchers a better understanding of complex disorders like Auditory Processing Disorders. Dr. Carmen Brewer, Chief of the Audiology Clinic at NIDCD participated in the study and explains how we use our auditory processing skills and how they are related to our genes.

Carmen Brewer: “When we talk about auditory processing were talking about basically what happens to incoming sound after the cochlea converts it from sound waves to neural –energy. How do we use after it goes up to through the brainstem and up to the brain? And there are many aspects of auditory processing—including Dichotic listening but by no means limited to, it includes our ability to localize, our ability to hear background noise, how well we hear signals that are filtered or that are fast signals that just aren’t real clear signals. We all experience that on our cell phones sometimes. So auditory processing is very complex and we’ve taken this one piece of it-Dichotic listening and been able to show that hereditary seems to be the major determinant on how well you do on the tests that we gave.”

VO: One of the tests conducted in this study were done with Identical and Fraternal Twins where they had to listen to two different one-syllable or nonsense syllables such as ba, da, and ka in each ear simultaneously.

Brewer: “ So it all boils down to your ability to hear both things, process both things, keep them separate in your brain and be able to repeat them back. Now when would you do that? Well, you’re not likely to have one person whispering in one ear and one person whispering in the other ear. But you might be on the phone with someone and have the phone up against your ear and have somebody call you from the other side. Or in a situation nowadays where so many of us have IPODs in our ears and some people do put an ipod in one ear and leave the other ear open when they need to be listening for something going on. Those are probably the most common situations is phone on one ear and speech going on in the other.

VO: Chris Zalewski, a Clinical Research Audiologist for NIDCD explained the goal of this study.

Chris Zalewski: “ Processing sound is a hereditable trait. What we discovered was that we did find some genetic factors on how we listen and how some things are governed by what the environment determines and some things on how we listen are governed by what is hereditable in our genes. And the take home message was how we process incoming sound individually by each ear and how the brain incorporates those two signals and often those two signals could be different is a hereditable trait.

VO: According to this study the environment that you are in can also affect not only how well you hear but it also affects what you can hear.

Zalewski: “How we process filtered speech, again, if we are having a conversation in the presence of a lot of noise, your speech doesn’t come off very clear. Sometimes it can be jumbled sometimes it can be influenced by the other noise within the environment, and how our brain processes that information, how we can dissect it, how we can actually come up with meaningful communication is important with how we auditorally process information.”

VO: For Eye on NIH, I’m Frances Sanchez

HOST: THANK YOU FRANCES. NOW FOR OUR EYE-TO-EYE INTERVIEW, WE TURN TO DR. JAMES KILEY, THE DIRECTOR OF THE DIVISION OF LUNG DISEASES AT OUR NATIONAL HEART LUNG AND BLOOD INSTITUTE TO TALK ABOUT CHRONIC OBSTRUCTIVE PULMONARY DISEASE, OR COPD. WE STARTED BY ASKING, WHAT EXACTLY IS COPD.

DR. KILEY: COPD, FIRST OF ALL STANDS FOR… THIS IS A SERIOUS LUNG DISEASES… BECOME PARTIALLY COLLAPSED… BECAUSE OF MUCUS BUILD IP… COLLAPSE… YOU HAVE A DISEASE THAT RESULTS IN THE INABILITY TO MOVE AIR IN AND OUT OF THE LUNGS.

VO: WHAT ARE SOME OF THE SYMPTOMS, HOW WOULD I KNOW IF I HAVE IT?

DR. KILEY: COPD IS A DISEASE THAT SORT OF COMES ON GRADUALLY… BREATHLESSNESS… YOU MAY BE COUGHING A LOT… GENERAL FEELING OF FATIGUE… THESE ARE ALL SYMPTOMS… THEN THEY GET MORE PROGRESSIVELY WORSE AS THE DISEASE GETS MORE SEVERE.

VO: WHAT PUTS PEOPLE AT RISK FOR COPD? WHAT ARE THE RISKS AND CAUSES?

DR. KILEY: ABSOLUTELY. AND THE BIGGEST ONE, AND WE ALL KNOW, IS SMOKING… WE KNOW THAT 80-90… 9 OUT OF 10 DEATHS… BUT WE DO KNOW THAT OTHER FACTORS, THERE’S CERTAINLY A GENETIC FACTOR… INHALATION OF OCCUPATOINAL FUMES… ONE OUT OF SIX PEOPLE WHO HAVE NEVER SMOKED GET COPD… WE NEED TO EDUCATE ABOUT THE VARIOUS RISK FACTORS… THAT THEY MAY NOT BE VERY FAMILIAR WITH.

VO: THAT’S A GOOD TRANSITION, IS THERE A CAMPAIGN GOING ON NOW?

DR. KILEY: YEAH, I WOULD LOVE TO TALK MORE ABOUT THAT… WE’RE VERY PASSIONATE ABOUT THIS… WAKE UP CALL… RAISING AWARENESS… FOURTH LEADING CAUSE OF DEATH… WE SHOULD ALL TAKE SOME NOTICE WHEN DISEASE IS KILLING… ONE PERSON EVERY FOUR MINUTES… GROWING IN EPIDEMIC PROPORTIONS… WE CAN DO SOMETHING ABOUT THIS DISEASE… IDENTIFY INDIVIDUALS EARLY… IMPROVE SYMPTOMS… QUALITY OF LIFE… WE REALLY NEED TO GET THE MESSAGE TO THOSE PEOPLE… IF THEY ARE AT RISK OR HAVE COPD.

VO: WHERE CAN PEOPLE LEARN MORE ABOUT COPD, I’M SURE THERE’S A WEBSITE, WHAT CAN PEOPLE FIND THERE?

DR. KILEY: LEARN ABOUT COPD.ORG IS THE WEBSITE… YOU CAN GET ACCESS TO A WHOLE RANGE OF MATERIALS… LITTLE CARDS… THERE’S VIDEOS… TOOLKIT… TO LEARN ABOUT THIS DISEASE… NOT ONLY AT RISK, BUT THOSE CARING… (5:34) WE REALLY HAVE A PUBLIC HEALTH URGENCY… IT’S A SMIPLE MESSAGE, IF YOU HAVE RISK FACTORS… EXPERIENCING SYMPTOMS… SPEAK TO YOUR DOCTOR… THERE ARE TREATMENTS AVAILABLE TODAY… WE THINK THAT IF WE CAN GET THE MESSAGE OUT… THEN WE CAN IMPACT THEIR CARE AND IMPROVE THEIR QUALITY OF LIFE.

VO: AND WHAT KIND OF CURRENT RESEARCH IS BEING DONE RIGHT NOW THAT YOU MIGHT WANT TO HIGHLIGHT?

DR. KILEY: WE HAVE A VERY WIDE SPECTRUM… FIRST, WE REALLY WANT TO UNDERSTAND MORE ABOUT GENETICS… WE KNOW THAT 1 IN 5 PEOPLE GET IT… WE REALLY NEED TO HAVE BETTER ANIMAL MODELS… WHAT’S GOING ON IN THE LUNG… LOOKING AT LUNG INJURY AND REPAIR… WE’D LIKE TO HALT THE PROGRESSION… WE HAVE NETWORKS SET UP FOR CLINICAL TRIALS… WE’RE HOPING THAT WE’LL GET SOME GOOD RESULTS… WE’RE SETTING THE FOUNDATION… BASIC SCIENCE, CLINICAL STUDIES… MOVE THAT INFORMATION IN THE HANDS OF THE PUBLIC… WE’D LIKE TO THINK WE CAN DO THAT… CAMPAIGN IS A BEAUTIFUL OUTLET TO TAKE RESULTS OF RESEARCH TO PUBLIC… THAT INFORMATION NEEDS TO GET IN THE HANDS OF THE PRACTITIONER BECAUSE THEY’RE THE ONES THAT CAN USE IT TO BENEFIT THE PATIENTS THEY SEE EVERY DAY.

HOST: THANKS FOR TUNING IN FOR THIS EPISODE OF EYE ON NIH. BE SURE TO CHECK OUT NEXT MONTH’S PROGRAM. WE’RE PUTTING TOGETHER STORIES ABOUT HOLIDAY DIETS, USING SALIVA TO TEST FOR DISEASES, AND MUCH MORE. PLEASE JOIN US THEN. FOR EYE ON NIH, I’M JOE BALINTFY.