CORVALLIS, Ore. – A new study suggests that nicotinamide, more commonly known as vitamin B3, may be able to combat some of the antibiotic-resistance staph infections that are increasingly common around the world, have killed thousands and can pose a significant threat to public health.
The research found that high doses of this vitamin increased by 1,000 times the ability of immune cells to kill staph bacteria. The work was done both in laboratory animals and with human blood.
The findings were published Tuesday, Aug. 28, in the Journal of Clinical Investigation by researchers from Cedars-Sinai Medical Center, the Linus Pauling Institute at Oregon State University, UCLA, and other institutions. The research was supported by several grants from the National Institutes of Health.
The work may offer a new avenue of attack against the growing number of “superbugs.”
“This is potentially very significant, although we still need to do human studies,” said Adrian Gombart, an associate professor in OSU’s Linus Pauling Institute. “Antibiotics are wonder drugs, but they face increasing problems with resistance by various types of bacteria, especially Staphylococcus aureus.
“This could give us a new way to treat staph infections that can be deadly, and might be used in combination with current antibiotics,” Gombart said. “It’s a way to tap into the power of the innate immune system and stimulate it to provide a more powerful and natural immune response.”
The scientists found that clinical doses of nicotinamide increased the numbers and efficacy of “neutrophils,” a specialized type of white blood cell that can kill and eat harmful bacteria.
The nicotinamide was given at megadose, or therapeutic levels, far beyond what any normal diet would provide – but nonetheless in amounts that have already been used safely in humans, as a drug, for other medical purposes.
However, there is no evidence yet that normal diets or conventional-strength supplements of vitamin B3 would have any beneficial effect in preventing or treating bacterial infection, Gombart said, and people should not start taking high doses of the vitamin.
Gombart has been studying some of these issues for more than a decade, and discovered 10 years ago a human genetic mutation that makes people more vulnerable to bacterial infections.
In continued work on the genetic underpinnings of this problem, researchers found that nicotinamide had the ability to “turn on” certain antimicrobial genes that greatly increase the ability of immune cells to kill bacteria.
One of the most common and serious of the staph infections, called methicillin-resistant S. aureus, or MRSA, was part of this study. It can cause serious and life-threatening illness, and researchers say the widespread use of antibiotics has helped increase the emergence and spread of this bacterial pathogen.
Dr. George Liu, an infectious disease expert at Cedars-Sinai and co-senior author on the study, said that “this vitamin is surprisingly effective in fighting off and protecting against one of today’s most concerning public health threats.” Such approaches could help reduce dependence on antibiotics, he said.
Co-first authors Pierre Kyme and Nils Thoennissen found that when used in human blood, clinical doses of vitamin B3 appeared to wipe out the staph infection in only a few hours.
Serious staph infections, such as those caused by MRSA, are increasingly prevalent in hospitals and nursing homes, but are also on the rise in prisons, the military, among athletes, and in other settings where many people come into close contact.
SACRAMENTO – The California Department of Public Health (CDPH) cited 14 California hospitals today for administrative penalties after determining that the facilities’ noncompliance with licensing requirements caused, or was likely to cause, serious injury or death to patients.
The fines total $825,000.
“We have a commitment to ensuring quality patient care for every Californian,” said Dr. Ron Chapman, director of CDPH and the state public health officer. “We work with hospitals to ensure they meet licensing requirements and share our goal of excellence in care.”
The following hospitals received penalties:
– California Hospital Medical Center – Los Angeles, Los Angeles, Los Angeles County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to the initiation of cardiopulmonary resuscitation. The penalty is $75,000. This is the hospital’s second administrative penalty.
– Fountain Valley Regional Hospital and Medical Center, Fountain Valley, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to the competency of a licensed vocation nurse. The penalty is $25,000. This is the hospital’s third administrative penalty.
– John F. Kennedy Memorial Hospital, Indio, Riverside County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery. The penalty is $50,000. This is the hospital’s fifth administrative penalty.
– Kaiser Foundation Hospital – Los Angeles, Los Angeles, Los Angeles County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to cardiac monitoring. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Kaiser Foundation Hospital – San Francisco, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to self-administered bedside medications. The penalty is $100,000. This is the hospital’s third administrative penalty.
– Kaiser Foundation Hospital – South San Francisco, South San Francisco, San Mateo County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $75,000. This is the hospital’s second administrative penalty.
– Menlo Park Surgical Hospital, Menlo Park, San Mateo County: The hospital failed to ensure the health and safety of a patient when it did not follow established surgical policies and procedures. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Saint Agnes Medical Center, Fresno, Fresno County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $50,000. This is the hospital’s fourth administrative penalty.
– Saint Francis Memorial Hospital, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Simi Valley Hospital & Health Care Services, Simi Valley, Ventura County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo an additional surgery to remove a retained foreign object. The penalty is $25,000. This is the hospital’s first administrative penalty.
– St. Jude Medical Center, Fullerton, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. The penalty is $100,000. This is the hospital’s fourth administrative penalty.
– St. Mary’s Medical Center, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient during a transfer. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Stanford Hospital, Stanford, Santa Clara County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to tracheostomy care. The penalty is $50,000. This is the hospital’s first administrative penalty.
– University of California, Irvine Medical Center, Orange, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $75,000. This is the hospital’s fourth administrative penalty.
Administrative penalties are issued under authority granted by Health and Safety Code section 1280.1.
Incidents that occurred prior to 2009 carry a fine of $25,000. New legislation took effect Jan. 1, 2009, that increased fines for incidents that occurred in 2009 or later.
Under the new provisions, an administrative penalty carries a fine of $50,000 for the first violation, $75,000 for the second, and $100,000 for the third or subsequent violation by the licensee. Incidents that occurred prior to 2009 are not counted when determining the fine amounts.
When hospitals receive their survey findings, they are required to provide CDPH with a plan of correction to prevent future incidents.
Hospitals can appeal an administrative penalty by requesting a hearing within 10 calendar days of notification. If a hearing is requested and the penalty upheld following an appeal, the penalties must be paid.
All hospitals in California are required to be in compliance with applicable state and federal laws and regulations governing general acute care hospitals, acute psychiatric hospitals, and special hospitals. The hospitals are required to comply with these standards to ensure quality of care.
SACRAMENTO –The California Department of Public Health (CDPH) on Thursday reported four additional cases of Hantavirus Pulmonary Syndrome (HPS), bringing the total number of people infected with the hantavirus who visited Yosemite National Park to six.
“CDPH is working closely with the National Park Service and the Centers for Disease Control and Prevention to further investigate the cluster of Hantavirus Pulmonary Syndrome cases in Yosemite and reduce the risk of other visitors becoming ill from this virus,” said CDPH Director, Dr. Ron Chapman. “CDPH is continuing to monitor cases of Hantavirus Pulmonary Syndrome in persons who visited Yosemite National Park.”
To date, HPS has been confirmed in six persons who visited the park between early June and mid July 2012.
Five are California residents and one is a resident of Pennsylvania.
The Pennsylvania patient and one California patient have died, three have recovered and one is currently hospitalized but improving.
Four, including both fatalities, lodged in the “signature cabins” of the Boystown area of Curry Village, one lodged in an unspecified area of Curry Village, and one is still under investigation.
The six individuals infected are residents from the Sacramento region, San Francisco Bay area, Southern California and one from Pennsylvania.
On Aug. 28, per recommendations from CDPH, Yosemite National Park closed all tent cabins in the Boystown area indefinitely.
The National Park Service has issued communications to guests who had stayed in the Boystown area between June 10 and Aug. 24, alerting them to the HPS concerns and recommending that they seek medical attention if ill.
Since HPS was first identified in 1993, there have been 63 cases – 21 fatal – in California.
The recent cases bring the total California case count for 2012 to seven; one of the recent patients infected in Yosemite was not a California resident.
HPS is caused by a virus that individuals get through contact with aerosolized urine, droppings or saliva of infected wild mice, primarily deer mice.
Breathing small particles of mouse urine or droppings that have been stirred up into the air is the most common means of acquiring infection.
The illness starts one to six weeks after exposure with fever, headache, and muscle ache, and progresses rapidly to severe difficulty in breathing and, in some cases, death.
When you are in wilderness areas or places where mice are present, you can take the following steps to prevent HPS:
A non-emergency phone line for questions and concerns related to hantavirus in Yosemite has been set up.
Visitors with questions can call 209-372-0822. The phones will be staffed from 9 a.m. to 5 p.m. daily.
For additional information on preventing HPS, visit CDPH’s Hantavirus Cardiopulmonary Syndrome page, http://www.cdph.ca.gov/HealthInfo/discond/Pages/HantavirusPulmonarySyndrome.aspx , and the federal Centers for Disease Control and Prevention’s Hantavirus Web site, http://www.cdc.gov/hantavirus/index.html .
Lack of sleep is linked to more aggressive breast cancers, according to new findings published in the August issue of Breast Cancer Research and Treatment by physician-scientists from University Hospitals Case Medical Center’s Seidman Cancer Center and Case Comprehensive Cancer Center at Case Western Reserve University.
Led by Cheryl Thompson, PhD, the study is the first-of-its-kind to show an association between insufficient sleep and biologically more aggressive tumors as well as likelihood of cancer recurrence.
The research team analyzed medical records and survey responses from 412 post-menopausal breast cancer patients treated at UH Case Medical Center with Oncotype DX, a widely utilized test to guide treatment in early stage breast cancer by predicting likelihood of recurrence.
All patients were recruited at diagnosis and asked about the average sleep duration in the last two years.
Researchers found that women who reported six hours or less of sleep per night on average before breast cancer diagnosis had higher Oncotype DX tumor recurrence scores.
The Oncotype DX test assigns a tumor a recurrence score based on the expression level of a combination of 21 genes.
“This is the first study to suggest that women who routinely sleep fewer hours may develop more aggressive breast cancers compared with women who sleep longer hours,” said Dr. Thompson, who is Assistant Professor at Case Western Reserve University School of Medicine and lead author. “We found a strong correlation between fewer hours of sleep per night and worse recurrence scores, specifically in post-menopausal breast cancer patients. This suggests that lack of sufficient sleep may cause more aggressive tumors, but more research will need to be done to verify this finding and understand the causes of this association.”
The authors point out that while the correlation of sleep duration and recurrence score was strong in post-menopausal women, there was no correlation in pre-menopausal women.
It is well known that there are different mechanisms underlying pre-menopausal and post-menopausal breast cancers.
The data suggest that sleep may affect carcinogenic pathway(s) specifically involved in the development of post-menopausal breast cancer, but not pre-menopausal cancer.
“Short sleep duration is a public health hazard leading not only to obesity, diabetes and heart disease, but also cancer,” said Li Li, MD, PhD, a study co-author and family medicine physician in the Department of Family Medicine at UH Case Medical Center and Associate Professor of Family Medicine, Epidemiology and Biostatistics at Case Western Reserve University School of Medicine. “Effective intervention to increase duration of sleep and improve quality of sleep could be an under-appreciated avenue for reducing the risk of developing more aggressive breast cancers and recurrence.”