Scientists at the University of Michigan have, for the first time, succeeded in growing 3D mini lungs from human stem cells, and the resulting structures resemble both the large proximal airways and the small distal airways. The advantage of growing 3D structures is that their organization bears greater similarity to the human lung.

First 3D Mini Lungs

The ingredients included in the process were embryonic stem cells, proteins involved in lung development, growth factors, inhibitors of intestine development, growing media, petri dish, protein mixture, and method for 'morphogenesis in a dish.' Researchers first, added the protein ActivinA to stem cells and left them for four days. Then they added Noggin, another protein, and a transforming growth factor, and left it for another four days. Researchers found the endoderm is induced to form 3D spherical structures called the foregut spheroids. These spheroids were then transferred to protein mixture and incubated at room temperature for 10 minutes until the mixture solidifies. They were treated with additional proteins every four days and transferred into a new protein mixture every 10-15 days. 

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The resulting lung organoids were able to survive in culture for over 100 days and develop into well-organized structures containing cell types found in the lung. The lung organoids are self-organizing, and do not require further manipulation to generate 3-dimensional tissues. Since these structures were developed in a petri dish, they lack several components of the native lung, including blood vessels, which are a critical component of gas exchange. 

The study appears in eLife.

This news is republished from site http://www.medindia.net/news/us-scientists-develop-first-3d-mini-lungs-from-human-stem-cells-147713-1.htm#ixzz3VYkoL0RX

A review published today by The Lancet Infectious Diseases warns of a potential upsurge in mosquito and tick-borne diseases across Europe as the climate gets warmer

Insects, such as mosquitoes and ticks, are responsible for transmitting a range of diseases, such as malaria, chikungunya, dengue fever, and West Nile virus. The risk of contracting such illnesses is generally only considered when booking an exotic holiday. However, experts from the Emergency Response Department at Public Health England have warned that climate change could allow such vector-borne diseases to emerge closer to home.

In the last 10 years, vector-borne diseases have emerged in new areas across Europe, eg, malaria in Greece, West Nile virus in Eastern Europe, chikungunya in Italy and France. The authors predict that disease-carrying mosquitoes may also become prevalent in the UK within the next few decades as the climate becomes increasingly mild and wet. Such conditions provide ideal breeding conditions for the Asian tiger mosquito (Aedes albopictus), which spreads the viruses that cause dengue and chikungunya. The mosquito responsible for the transmission of West Nile virus (Culex modestus) has already been identified at a number of sites across Kent, although there is currently no indication of virus transmission.

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Author of the review, Dr Medlock commented “Given the ongoing spread of invasive mosquitoes across Europe, with accompanying outbreaks of dengue and chikungunya virus, Public Health England has been conducting surveillance at seaports, airports, and some motorway service stations. Although no non-native invasive mosquitoes have been detected in the UK so far, a better system to monitor imported used tyres, in which disease-carrying mosquitoes lay their eggs, needs planning”

Dengue fever is currently considered to be a tropical disease, since the larvae and eggs of the transmitting mosquito cannot survive freezing temperatures. However, climate change models indicate that by 2030 temperatures will have risen sufficiently to enable the Aedes mosquito to survive across large parts of England and Wales.

Author Professor Leach added “We are not suggesting that climate change is the only or the main factor driving the increase in vector-borne diseases in the UK and Europe but that it is one of many factors, including socioeconomic development, urbanisation, widespread land-use change, migration, and globalisation, that should be considered.”

In order to avoid future outbreaks of vector-borne diseases, we must ensure that public health systems worldwide have the ability to adapt to cope with the infectious diseases that might result from climate change.

This new is republished form site http://www.news-medical.net/news/20150323/Insect-borne-diseases-increase-with-warmer-climate.aspx

Women who give birth to four or more children are more likely to have cardiovascular changes that can be early indicators of heart disease than women who have fewer children, new research by UT Southwestern Medical Center cardiologists finds.

"This study adds to a body of evidence that pregnancy, which generally occurs early in a woman's life, can provide insight into a woman's future cardiovascular risk," said Dr. Monika Sanghavi, Assistant Professor of Internal Medicine and lead author of the study

Using data gathered for the Dallas Heart Study, researchers compared the number of live births reported by women in the study with their coronary artery calcium (CAC) levels and aortic wall thickness (AWT). High levels of coronary artery calcification and thicker aortic walls are markers of heart disease that show up before symptoms develop.

Women were divided into three groups: One or no live births, two to three live births, and four or more live births. Women who reported four or more live births had a 27 percent prevalence of a high calcium score compared with 11 percent among those with two to three live births. The trend was similar when looking at AWT measurements.

The associations were not affected by adjusting for socioeconomic status or traditional cardiovascular risk factors, suggesting that physiological changes associated with pregnancy may account for the change, Dr. Sanghavi said.

Further studies will be needed to identify the causes, but researchers said one possibility might be that women who have many pregnancies may have more visceral fat (fat around abdominal organs), which has been linked to increased heart disease risk. Another possibility could be that increased cholesterol and higher blood sugar associated with pregnancy may lead to increased risk.

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"During pregnancy, a woman's abdominal size increases, she has higher levels of lipids in her blood, and higher blood sugar levels," Dr. Sanghavi said. "Each pregnancy increases this exposure."

The study also found slightly higher rates of high CAC and AWT measurements among women who had one or no children, compared with women who gave birth to two or three children, suggesting a U-shaped association between number of births and heart disease, with the lowest risk at two or three births.

"It's likely that there is a different mechanism for the increased risk at the low end," Dr. Sanghavi said. "Some of these women could have some underlying disease that prevents them from carrying births to term and increases their risk for heart disease."

"We are learning that there are numerous physiologic changes during pregnancy that have consequences for future heart health," said senior author Dr. Amit Khera, Associate Professor of Internal Medicine, who directs the Preventive Cardiology Program and holds the Dallas Heart Ball Chair in Hypertension and Heart Disease. "This study reminds us of the importance of taking a pregnancy history as part of cardiovascular disease screening."

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We have all been there; whether in class at school or a meeting at work, sometimes it feels as if our brain just gives up and leaves the building. But according to a new study by researchers from Saarland University in Germany, a short daytime nap could significantly boost brain power.

Publishing their findings in the journal Neurobiology of Learning and Memory, the team reveals that a sleep of around 45-60 minutes could improve learning and memory by fivefold.

This is not the first study to associate daytime napping with improved memory performance. In January,Medical News Today reported on a study by researchers from the University of Sheffield in the UK, who found that a 30-minute nap within 4 hours of a learning task significantly improved infants' memory.

But this latest study reveals that power naps may also benefit memory for adults, with the team revealing how a short sleep may affect the brain to produce this outcome.

To reach their findings, study leader Alex Mecklinger, of the Experimental Neuropsychology Unit at Saarland, and his team enrolled 41 participants to take part in a learning task.

Participants were shown a list of 90 single words and 120 unrelated word pairs and were asked to learn them. The researchers explain that unrelated word pairs were used in order to eliminate the possibility that participants may have remembered the words as a result of familiarity.

"A word pair might, for example, be 'milk-taxi.' Familiarity is of no use here when participants try to remember this word pair," explains Mecklinger, "because they have never heard this particular word combination before and it is essentially without meaning. They therefore need to access the specific memory of the corresponding episode in the hippocampus."

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After the learning task, participants were immediately required to complete a memory recall test. Half of the participants were then asked to take a nap of up to 90 minutes, while the remaining subjects were asked to watch a DVD.

The brain activity of the napping participants was measured via electroencephalogram (EEG) while they slept, with the team specifically focusing on "sleep spindles" - a burst of activity in the hippocampus region that plays a key role in memory consolidation.

"We suspect that certain types of memory content, particularly information that was previously tagged, is preferentially consolidated during this type of brain activity," says Mecklinger.

Next, all participants were asked to retake the memory recall test, requiring them to once again remember the words and word pairs shown to them prior to napping or watching a DVD.

Better learning, memory linked to greater number of sleep spindles during nap

The researchers found that, compared with participants who watched the DVD, those who napped for around 45-60 minutes following the learning task performed approximately five times better when it came to remembering the word pairs.

In fact, the researchers note that word pair recall of the napping participants was just as good as it was on the memory tests completed immediately after learning.

Short naps were not associated with improvement in item memory - the ability to remember phone numbers, for example, or a friend's name - the team says.

According to the researchers, these findings suggest that a short nap can significantly boost associative memory - the ability to remember a link between items that are unrelated, such as the name of a person we have just met.

What is more, the team found that better learning and memory recall was associated with a greater number of sleep spindles in the EEG, supporting their theory that sleep spindles play a role in specific forms of memory; in this case - associative memory.

Commenting on their findings, Mecklinger says:

"A short nap at the office or in school is enough to significantly improve learning success. Wherever people are in a learning environment, we should think seriously about the positive effects of sleep."

Earlier this month, MNT reported on a study published in Nature Neuroscience, in which researchers found our head-direction cells - the "internal compass" that tells us which direction we should face - continue to be active during sleep.

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Breast really is best

FOUR extra points of IQ, an extra year’s education and a significantly enhanced income at the age of 30. Those are the benefits of having been breast-fed, according a study just published in Lancet Global Health by Bernardo Horta of the Federal University of Pelotas, in Brazil, and his colleagues.

Previous research has suggested that breast-feeding has beneficial long-term effects. But Dr Horta’s work is particularly persuasive because it looks at adults rather than children and teenagers, and because it contradicts the suggestion that social class is a confounding variable, with rich mothers tending to breast-feed more than poor mothers do.

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The participants in the study were among a group of Brazilians born in Pelotas in 1982. Following a cohort like this through their lives is an established method of medical research. It lets doctors test hypotheses that retrospective examination, relying on memory, cannot address reliably. In 2012 and 2013 Dr Horta managed to track down 3,493 members of the cohort whose diet as babies, including their consumption of breast milk, had been recorded at the time, ask them some questions, and give them an IQ test.

Comparing those who, as babies, had been breast-fed for less than a month with those who had been so fed for more than a year, Dr Horta found the latter’s IQ was 3.76 points higher than the former’s and that they had attended school for 0.91 years longer. The income data were slightly more complicated. Those breast-fed for over a year had incomes 15% higher than those suckled for less than a month, but those breast-fed for six to 12 months did even better, at 55%. These effects, moreover, were unaffected by a family’s income at the time a study participant was born.

The reasons for this are not known for certain, though it is easy to speculate. Human milk has, presumably, been optimised for human nutrition by evolution. The social contact involved in suckling may also have an effect. But the underlying cause is less important than the result. As Winston Churchill once said, “there is no finer investment for any community than putting milk into babies.” Add the word “mother’s” in front of “milk”, and the returns on that investment get finer still.

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Heart Health

9 subtle signs you could have a heart problem

Thanks to more education about healthy eating and advancements in treatment, fewer people die of heart disease than in the past. That said, clogged heart arteries are still the number-one cause of death in the United States. Although heart attack symptoms can be a scary first sign of trouble (and keep in mind women have different symptoms than men), sometimes the body offers up more subtle clues that something is amiss with your ticker. The following is a list of symptoms that might be worth a chat with your doctor. But they may also be caused by a bunch of other things, so don't freak out. Only your real doctor—not Dr. Google—can really tell you if these symptoms mean anything at all.

You're extremely tried
This isn't just lack of sleep tired; it is extreme fatigue. Think of how you feel when you get the flu, except this doesn't go away.

"A lot of women kind of blow this off assuming it's nothing and that they will feel better, but in reality it could be a sign of your heart," said Suzanne Steinbaum, DO, Director of Women's Heart Health at the Heart and Vascular Institute at Lenox Hill Hospital in New York City.

The reason why you feel that way: It comes down to a lack of oxygen. "The heart is struggling and straining to deliver the oxygen to your body." That said, plenty of people feel tired for lots of reasons. If this is your only symptom, you can talk to your doctor, but don't conclude you have heart trouble based on this alone.

RELATED: 15 Signs You May Have an Iron Deficiency

Your feet swell
Feet swelling can occur for a bunch of garden-variety reasons, such as pregnancy, varicose veins (which are unsightly but not dangerous), or when you travel and have limited ability to move around. It can also be a sign of heart failure, a chronic condition in which the heart pumps blood inefficiently.

"Swelling can also occur when the heart valve doesn't close normally," said Dr. Michael Miller, professor of cardiovascular medicine at the University of Maryland School of Medicine.

Some medications for blood pressure and diabetes could also cause swelling, Miller said.
"Heart-related foot swelling is usually accompanied by other symptoms that include shortness of breath and/or fatigue," he said.

If you recently developed foot swelling, see your doctor to determine the cause and how best to treat it.

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You have extreme pain when you walk
If your hip and leg muscles cramp when you climb, walk, or move, then feel better when you rest, don't shrug it off as due to old age or a lack of exercise (though those things certainly could be the culprits). It could be a sign of peripheral arterial disease, also known as PAD. PAD is a buildup of fatty plaque in leg arteries that is linked to a higher risk of heart disease. If you have PAD there's a 50 percent chance you also have a blockage in one of the heart arteries, Miller said. The good news? PAD (and heart disease for that matter) is a very treatable condition.

RELATED: 12 Worst Habits for Your Mental Health

You get dizzy or light-headed
Again, this is one of those symptoms that can have many non-heart related causes. If you have ever been to a gym, you may have seen warning signs to stop walking, running, cycling or elliptical stepping if you feel dizzy or light-headed. This symptom could be caused by dehydration or because you "got up too quick," but if it occurs on a regular basis then talk to your doctor to see if medication side effects, inner ear problems, anemia, or, less commonly, heart issues are to blame. This spinning state could be caused by blockages in arteries that lessen blood pressure or by faulty valves that cannot maintain blood pressure, Miller said.

You get short of breath, even though you're fit
Despite your thrice-weekly cycling classes, you get winded walking up a flight of stairs or you're coughing a lot. What gives? It could be asthma, anemia, an infection, or rarely a problem with the heart's valves or its ability to pump blood.

"Fluid buildup affecting the left side of the heart can produce wheezing that simulates bronchial asthma," Miller said. "Once the valve is fixed, fluid no longer builds up in the lungs and the patient breathes easier."

Since exercise can strengthen the heart, get this symptom checked out so it doesn't interfere with your ability to get a good workout.

You're depressed
Depression is one of the most common problems in the world, and it affects 19 million Americans each year. Depression is probably not a sign that you have heart trouble (as if you need something else to worry about.) But mental wellbeing is linked to physical wellbeing; many studies suggest that people who are depressed are at greater risk of heart trouble.

"People who have multiple risk factors for heart disease or who do have heart disease have a tendency to be depressed," Steinbaum said.

Either way you look at it, it's another reason to seek help if you are depressed.

RELATED: 10 Signs You Should See a Doctor for Depression

You get migraines
Sometimes a headache is just a headache. But in some cases, regular migraines suggest that something is amiss with your ticker. Migraines occur in 12 percent of the general population, but that stat rises to around 40 percent in patients with cardiovascular disease. And while there isn't a clear-cut connection, the occurrence of migraines with auras has been related to some heart abnormalities, so it is possible that these attacks might have a connection to dysfunction of the heart. One theory is that they could both are the result of autonomic nervous system imbalances.

You can hear your heart beat when you fall asleep at night
"Some patients with a loud faulty valve can even hear the sound of their valve at night when they are trying to fall asleep," Miller said.

And while some patients adjust to the sound and often just change their sleeping position so as not to hear it, doesn't mean you should ignore it. If you're being lulled to sleep by the thump-thump of your heart, tell your doctor so he or she can find out why. A pounding heartbeat can also be a sign of low blood pressure, low blood sugar, anemia, medication, dehydration, and other causes.

RELATED: 25 Surprising Ways Stress Affects Your Health

Anxiety, sweating, and nausea attack you all at once
You're suddenly anxious, sweating, and nauseous. These are classic symptoms of a panic attack, but they are also heart attack symptoms. If these early heart symptoms are followed up with shortness of breath (though you haven't moved a muscle), extreme fatigue, or accompanied by pain, fullness, or aching in the your chest that may (or may not) radiate to the back, shoulders, arm, neck, or throat, then get to an emergency room immediately. Waiting more than five minutes to take action could change your chances of survival. In fact, those who arrive at the hospital within an hour of heart attack symptoms starting have better survival rate than those who wait.

This article originally appeared on Health.com.

The world's first human head transplant: could it happen in the next 2 years?

human head transplantation

I may sound like something from a horror movie, but at the American Academy of Neurological and Orthopedic Surgeons' 39th Annual Conference in Annapolis, MD, in June, an Italian surgeon will announce updated plans to conduct the first ever human head transplant, claiming the procedure could happen within the next 2 years.

Dr. Sergio Canavero, of the Turin Advanced Neuromodulation Group (TANG) in Italy, believes the revolutionary procedure - named HEAVEN-GEMINI - could save the lives of people with metastatic cancer or muscle-wasting disorders, such as muscular dystrophy.

Medical News Today first reported on Dr. Canavero's proposal in July 2013. Back then, he noted some challenges for human head transplantation: reconnecting the severed spinal cord, and preventing the immune system from rejecting the head.

In an editorial recently published in the journal Surgical Neurology International, Dr. Canavero says he believes these challenges can now be overcome, noting that recent animal studies have confirmed human head transplantation is "feasible."

The idea of head transplantation is not new. In 1970, US neurosurgeon Dr. Robert White transplanted a monkey's head onto another monkey's body. Though the animal was able to see, hear, taste and smell, it was left paralyzed because surgeons did not have the technology to fuse the monkey's spinal cord nerves to its head. It died 9 days following the procedure, after the animal's immune system rejected its head.

But in his editorial, Dr. Canavero points to a 2014 study in which German researchers successfully reconnected the severed spinal cords of rats, suggesting the same technique could be applied to humans.

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In addition, the researcher believes modern drugs mean the possibility of immune rejection is not as challenging as it once was. William Matthews, chairman of the American Academy of Neurological and Orthopedic Surgeons (AANOS) told New Scientist magazine that the immune response to a head transplant should be manageable. "The system we have for preventing immune rejection and the principles behind it are well established," he added. What will the HEAVEN-GEMINI procedure involve?

Both the recipient's head and the donor body will be placed in "hypothermia mode" for approximately 45 minutes, which is believed to eliminate any neurological damage that may be caused by lack of oxygen.

The head will be removed from the donor body using an "ultra-sharp blade" in order to limit damage to the spinal cord. "The key to SCF [spinal cord fusion] is a sharp severance of the cords themselves," Dr. Canavero explains, "with its attendant minimal damage to both the axons in the white matter and the neurons in the gray laminae. This is a key point."

The recipient's head will then be attached to the donor body. This is the most difficult part of the procedure, which will involve fusing the end of spinal cord in the body with that of the head. Dr. Canavero says chemicals called polyethylene glycol (PEG) or chitosan can be used to encourage SCF. Next, the muscles and the blood supply will be sutured.

In his original proposal, Dr. Canavero said the procedure is likely to take 36 hours to complete and require the skills of 100 surgeons.

Once the surgery is complete, the recipient will be kept in a coma for around 3-4 weeks to avoid neck movements and give the nerve connections time to fuse. During this time, the recipient's spinal cord would be subject to electrical stimulation via implanted electrodes, with the aim of enhancing the new nerve connections.

Dr. Canavero told New Scientist that once the recipient awakes, they will be able to move their whole body and their voice would sound the same. He believes that the patient will be able to walk within 1 year with the help of physical therapy.

The ethics 'is a real stumbling block'

It is not surprising that many researchers are skeptical about Dr. Canavero's proposal, claiming it is too far-fetched to work.

"This is such an overwhelming project, the possibility of it happening is very unlikely," Harry Goldsmith, a clinical professor of neurosurgery at the University of California-Davis told New Scientist. "I don't believe it will ever work, there are too many problems with the procedure. Trying to keep someone healthy in a coma for 4 weeks - it's not going to happen."

In addition, the procedure has raised many ethical concerns. In 2013, Dr. Canavero said there is a worry that, without sufficient regulation, the procedure may one day lead to wealthy, aging individuals securing the healthy bodies of young individuals on the black market, with "unscrupulous" surgeons carrying out the head transplantation.

Still, he believes the HEAVEN-GEMINI procedure has the potential to save lives, and he hopes his proposal at the AANOS Annual Conference will attract some support for the world's first human head transplantation - particularly from the US.

Dr. Canavero told New Scientist:

"The real stumbling block is the ethics. Should this surgery be done at all? There are obviously going to be many people who disagree with it.

If society doesn't want it, I won't do it. But if people don't want it in the US or Europe, that doesn't mean it won't be done somewhere else. I'm trying to go about this the right way, but before going to the moon, you want to make sure people will follow you."

Written by Honor Whiteman

This news is republish from site  http://www.medicalnewstoday.com/articles/290127.php

Clinical trials are research studies to determine whether drugs or treatments are both safe and effective for humans. All new medications and devices must undergo several clinical trials, usually involving thousands of people, before they can be released to the public.

Evidence from clinical trials helps identify which treatments work best. Without this evidence, there is a risk that people could be given treatments that have no advantage, waste NHS resources, and might even be harmful.
Clinical trials research is not just for researchers. Patients and the public can be involved too. New research cannot lead to reliable findings unless the right patients agree to join in.
Use this page to search for clinical trials. Information is provided by TrialReach.

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A new study led and funded by the Centers for Disease Control and Prevention finds that in 2011, Clostridium difficile was responsible for almost half a million infections and more than 15,000 deaths in the US. The Centers for Disease Control and Prevention (CDC) say the findings, which are published in The New England Journal of Medicine, emphasize how improvements in antibiotic use and infection control in health care settings are critical for tackling C. diff infection.

C. diff is a bacterium that causes colitis - inflammation of the colon. Infection can occur through touching surfaces or items that are contaminated with feces, in which C. diff is shed.

Symptoms of C. diff infection include fever, nausea, diarrhea, loss of appetite and abdominal pain.

People who are taking antibiotics for other illnesses are most prone to C. diff infection. Antibiotics can destroy some of the friendly bacteria in the gut, meaning it may be less protected against C. diff.

According to the CDC, more than half of patients who stay in hospital are treated with antibiotics, which is why health care settings have been identified as the primary source of transmission.

What is more, past research has shown around 30-50% of antibiotics prescribed in hospitals are not needed or incorrect, meaning many patients are being unnecessarily put at risk of C. diff infection and are putting others at risk by carrying the infection to other settings, such as nursing homes.

The aim of this latest study was to assess the burden of C. diff across the US.

Lead author Dr. Fernanda C. Lessa, a medical epidemiologist at the CDC, and his team set out to identify cases of C. diff infection over 10 geographic areas in the US in 2011.

Based on their findings, the team estimates that in 2011, around 453,000 people were infected with C. diff, and around 29,300 deaths occurred within 30 days of diagnosis. Of these deaths, around 15,000 were estimated to be directly attributable to C. diff.

The study found that individuals aged 65 and older are particularly vulnerable to C. diff infection. Around 1 in 3 cases occurred among patients in this age group, and they also accounted for 2 in 3 health care-associated C. diff infections. What is more, around 80% of C. diff-attributable deaths occurred in patients aged 65 or older.

The researchers also identified an increased risk of C. diff infection among women and Caucasian individuals.

Better infection control and antibiotic use needed across all health care settings
Around two thirds of C. diff cases were associated with stays in a health care facility, according to the research. Of these, almost a quarter occurred during hospitalization, and a similar number occurred in nursing homes. Patients who were recently discharged from a health care facility accounted for the remaining cases.

These results, the CDC say, emphasize the need for better infection control and antibiotic use in health care settings.

The organization points to a 2014 Vital Signs report that found that if hospitals reduced high-risk antibiotic use by 30%, the number of deadly diarrhea infections - such as C. diff - could be reduced by 26%. Another study found a 10% decrease in antibiotic use in different hospital wards was linked to a 34% reduction in C. diff infections.

The CDC note that more than 150,000 of the cases identified were community-associated, meaning the infection was not acquired in health care settings.

However, the organization points to a 2014 study published in JAMA Internal Medicine that found around 82% of patients with community-associated C. diff infection had reported visiting an outpatient health care facility - such as a doctor's or dentist's office - in the 12 weeks prior to diagnosis.

The CDC say these results indicate that improved antibiotic use and infection control needs to be put in place for outpatient health care, as well as inpatient facilities.

Dr. Michael Bell, deputy director of the Division of Healthcare Quality and Promotion at the CDC, says:

"Overall, there are two main things that need to be improved. Number one is how antibiotics are being used, making sure that we use them when they're truly necessary and only for as long as necessary.

The second element is to ensure rigorous infection control in all health care settings. C. diff infections must be diagnosed quickly and correctly so that the infected patient can be cared for using the right infection control techniques."

What are the CDC doing to tackle C. diff in health care settings?
The CDC say they are helping hospitals to develop programs - called "antibiotic stewardship" programs - aimed at improving antibiotic prescription for patients.

In addition, the organization has set up a number of resources to help all health care settings improve antibiotic prescription - such as the "Get Smart: Know When Antibiotics Work" campaign.

Since 2013, the CDC have required all hospitals that are taking part in the Centers for Medicare & Medicaid Services' (CMS) Hospital Inpatient Quality Reporting Program to report all C. diff information to their National Healthcare Safety Network. "This now lets us track and report the nation's progress in controlling this disease. So far we've seen at least a 10% reduction in infections since 2011," notes Dr. Bell.

However, Dr. Bell admits that more needs to be done to control C. diff infection in the US. As such, he says that C. diff prevention is to be included in the value-based purchasing program of the CMS, known as "pay for performance." This is a program that offers financial incentives to clinicians for improving health outcomes.

"In preparation for that, CDC are using a targeting strategy that identifies which hospitals are having infection issues so we and our partners in state and local health departments and agencies like CMS can deliver assistance where it's needed most," he adds.

"To reduce the majority of infections we'll need to improve how antibiotics are being prescribed in hospitals and throughout health care. If we can improve antibiotic prescribing, we expect to see rates of C. diff infections improve dramatically."

Medical News Today recently reported on a study by researchers from the University of Michigan in Ann Arbor, which claims to reveal how C. diff interferes with the gut.

Written by Honor Whiteman

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People who sleep more than eight hours a night may have an increased risk of stroke, according to a new study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study found that people who slept more than eight hours a night, called long sleepers, were 46 percent more likely to have a stroke than people who slept six to eight hours a night, which was considered an average amount of sleep. People who shifted over time from sleeping less than six hours a night to sleeping more than eight hours a night were nearly four times as likely to have a stroke as people who consistently slept an average amount.

The study involved 9,692 people with an average age of 62 who had never had a stroke. They were asked about their sleeping habits once and then again about four years later. The participants were followed for an average of 9.5 years. During that time, 346 people had a stroke.

Of the 986 people who slept more than eight hours a night, 52 had a stroke, compared to 211 of the 6,684 people who slept an average amount. The relationship between long sleep and stroke stayed the same after researchers accounted for factors such as high cholesterol, high blood pressure, body mass index and physical activity.

"We don't know yet whether long sleep is a cause, consequence or early marker of ill health," said study author Yue Leng, M.Phil., of the University of Cambridge in the United Kingdom. "More research is needed to understand the relationship between long sleep and stroke."

Alberto Ramos, MD, MSPH, of the University of Miami Miller School of Medicine and a member of the American Academy of Neurology, who wrote a corresponding editorial, said, "Since people whose sleep patterns changed from short to long were nearly four times as likely to have a stroke, it's possible that this could serve as an early warning sign, suggesting the need for additional tests or for people to take steps known to reduce stroke risk, such as lowering blood pressure and cholesterol."

Leng and her colleagues also conducted a meta-analysis, which is a review of previous studies on sleep duration and stroke. Those results also found an association between long sleep and stroke.

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