ANTIVIRAL THERAPY BENEFITS HIV INFECTED STIMULANT USERS

New clinical research from UC San Francisco shows that 341 HIV-infected men who reported using stimulants such as methamphetamine or cocaine derived life-saving benefits from being on antiretroviral therapy that were comparable to those of HIV-infected men who do not use stimulants.

That said, those who reported using stimulants at more than half of at least two study visits did have modestly increased chances of progressing to AIDS or dying after starting antiretroviral therapy compared to non-users. The data was collected between 1996 and 2012.

"Patients with HIV who use stimulants and other substances often experience difficulties with accessing antiretroviral therapy, partially due to the concerns of healthcare providers that they will not be able take their medications as directed. Findings from this study demonstrate that many stimulant users take their antiretroviral therapy at levels sufficient to avoid negative clinical outcomes. When we look at overall mortality, antiretroviral therapy leads to similar clinical benefits for both stimulant users and non-users, notwithstanding stimulant use," said the study's primary investigator, Adam W. Carrico, PhD., UCSF assistant professor of nursing.

The research is available starting in October online ahead of print in the Journal of Acquired Immune Deficiency Syndromes. The study included 1,313 HIV-infected men who have sex with men within the Multicenter AIDS Cohort Study, an ongoing nationwide prospective study of HIV infection among men who have sex with men in the U.S.

"If we are to achieve the goals of the President's National HIV/AIDS Strategy and UNAIDS to end the HIV/AIDS epidemic, we will need to treat HIV-positive active substance users for their HIV while encouraging them to stop or reduce their substance use. Programs integrating substance abuse services with HIV clinical care may both improve health outcomes for patients and reduce new infections," said Carrico.

The UCSF Division of HIV/AIDS at San Francisco General Hospital has created an integrated care delivery system that could serve as a model for other clinics, added Carrico. The HIV primary care clinic utilizes a patient centered team care approach that includes substance abuse services for stimulant and opioid users, along with mental health services, all located onsite. STOP, the "stimulant treatment outpatient program," within the clinic provides outpatient substance abuse and mental health treatment integrated with patients' primary medical care.

"The pattern of use varies and the real issue is whether patients can take their antiretrovirals as prescribed. We find that some patients are able to start taking antiretrovirals very reliably before they are able to decrease or stop their stimulant use, which often requires more complex behavioral, emotional, interpersonal and environmental changes. Being in an HIV primary care setting allows us to engage stimulant users even if they are not ready to go to specialty substance abuse programs or support groups," said Valerie Gruber, PhD, STOP director and UCSF professor of psychiatry.

HUNTING DOWN HIDDEN DANGERS AND HEALTH BENEFITS OF URBAN FRUITS

Forgotten trees from long lost orchards and 20th-century city landscaping are being rediscovered in urban areas, and their fruits are proving not only largely free of urban pollutants, but more nutritious than their retail counterparts.

Scientists at Wellesley College have joined forces with the League of Urban Canners (LUrC), based in Cambridge/Somerville and greater Boston area, to collect and eventually analyze 166 samples of apples, peaches, cherries and other urban fruits and herbs, collected from remnants of historical farms, urban parkland, and residential properties. The efforts grew out of concern for a LUrC member who was found to have high levels of lead in their blood. Members of LUrC wanted to make sure that the urban fruits they were harvesting and processing were not harboring toxic metals.

"This is a story with a good ending: not much lead in these urban harvested fruit," said Wellesley geosciences and environmental studies professor Dan Brabander, who has previously studied lead exposure risk in urban gardens and in areas impacted by historical mining activities.

The LUrC study investigated the concentrations of lead in urban fruits when they were peeled and unpeeled as well as washed and unwashed. That was intended to distinguish whether the fruits were taking up lead internally or being contaminated by dry deposition from the air or from soil dust.

"We found there was no difference between these variables," said Ciaran Gallagher, an undergraduate researcher majoring in Environmental Chemistry at Wellesley College, who will be presenting the research on Monday, Nov. 2 at the annual meeting of the Geological Society of America in Baltimore. Gallagher will be co-presenting with geoscience undergraduates Hannah Oettgen and Disha Okhai.

The researchers also looked at arsenic in the fruits, because in older orchards farmers commonly used lead arsenate as a pesticide. "So we are keeping an eye on places where this pesticide might have been historically applied." To date the researchers have not found evidence of use in the LUrC samples.

For the lead analysis, fourteen urban and eight commercial fruit samples were dried in a fruit dehydrator to mimic methods used by LUrC members in their home kitchens, and analyzed for trace elements. Gallagher and her colleagues found that the lead concentrations in urban apples ranged from 0.5 to 1.2 ug/g (dry weight basis). They then looked at the estimated consumption of the fruit to model how much lead the urban fruit eaters were being exposed to. The resulting finding suggest that eating urban fruit is not a significant source of lead exposure, when compared to the EPA regulated benchmark for lead in drinking water.

In addition to lead and arsenic, they also looked into the nutritional value of urban fruit. They compared micronutrient levels with those in commercially grown fruits and found that calcium concentrations in urban apples and peaches are more than 2.5 times those in their commercial counterparts. Concentrations of calcium and iron were higher in urban fruits for every fruit type tested, and manganese, zinc, magnesium, and potassium concentrations were higher in certain urban fruit types. On average, urban fruit contains a wider range of micronutrients than its commercial counterparts.

"When they grow in a commercial setting the soils can become quite impoverished," Brabander explained. "In the urban setting where the trees sampled tend to be older perhaps they are able to shuttle micronutrients from a wider and more diverse range of horizons." Planned future soil coring work into urban soils will try to figure out the mechanism of nutrient transfer in this unique setting.

"That's not to say that all urban produce is safe to eat, however, because local conditions vary and antique fruit trees are found in some very unexpected -- and sometimes very polluted places, like along major roadways," said Brabander.

"By working with the Wellesley researchers the LUrC members are able to get a much broader, clearer look at the health benefits and any potential health threats from urban fruit than they ever could have if they had randomly spot checked fruits," said Brabander.

"The citizen-science component to both study initiation and sampling is so central to how this project has been conceived and executed to date," said Gallagher. "Simply stated, without the League of Urban Canners, this project would not have been possible."

Brabander concludes, "The intersection of urban geohealth and citizen science is an emerging research paradigm for prioritizing projects that have immediate implications for designing best practices that promote a wide expression of safe and sustainable urban agriculture."

CHILI PEPPER MAY COME WITH BLOOD PRESSURE BENEFITS

For those with high blood pressure, chili peppers might be just what the doctor ordered, according to a study reported in the August issue ofCell Metabolism, a Cell Press publication. While the active ingredient that gives the peppers their heat -- a compound known as capsaicin -- might set your mouth on fire, it also leads blood vessels to relax, the research in hypertensive rats shows.

We found that long-term dietary consumption of capsaicin, one of the most abundant components in chili peppers, could reduce blood pressure in genetically hypertensive rats," said Zhiming Zhu of Third Military Medical University in Chongqing, China.

Those effects depend on the chronic activation of something called the transient receptor potential vanilloid 1 (TRPV1) channel found in the lining of blood vessels. Activation of the channel leads to an increase in production of nitric oxide, a gaseous molecule known to protect blood vessels against inflammation and dysfunction, Zhu explained.

The study isn't the first to look for a molecular link between capsaicin and lower blood pressure. However, earlier studies were based on acute or short-term exposure to the chemical, with some conflicting results. Zhu says their study is the first to examine the effects of long-term treatment with capsaicin in rats with high blood pressure.

The findings in rats should be confirmed in humans through epidemiological analysis, the researchers said. In fact, there were already some clues: the prevalence of hypertension is over 20% in Northeastern China compared to 10-14% in Southwestern China, including Sichuan, Guozhuo, Yunnan, Hunan, and Chongqing, where Zhu is from.

"People in these regions like to eat hot and spicy foods with a lot of chili peppers," Zhu says. "For example, a very famous local food in my hometown, Chongqing, is the spicy hot pot."

It isn't yet clear just how many capsaicin-containing chili peppers a day you'd have to eat to "keep the doctor away," although that's a question that should now be examined in greater detail, Zhu says.

For those who can't tolerate spicy foods, there might still be hope. Zhu notes the existence of a mild Japanese pepper, which contains a compound called capsinoid that is closely related to capsaicin.

"Limited studies show that these capsinoids produce effects similar to capsaicin," Zhu says. "I believe that some people can adopt this sweet pepper.

HEALTH BENEFITS OF WHITE TEA

White tea has been quite popular in China and has recently become popular in other parts of the world including India. It is made from immature tea leaves that are picked just before the buds have fully opened.

Here are a few health benefits of white tea:

-White tea is an excellent source of antioxidants and flavonoids that increases immunity. It also contains polyphenols that helps in dissolution of triglycerides which are deposited in our body.

-Drinking 2-3 cups of white tea a day helps in thinning of blood and thus keeps your heart in good health.-Studies suggest that drinking white tea can also help in controlling blood sugar levels thereby preventing diabetes.

-White tea is good for your skin as it prevents the skin from damage caused by free radicals.

-It helps lower high blood pressure and also keeps cholesterol in check.