| Key reason 'found' for gum and heart disease link Mon 6th September 2010 | Scientists say they have established one reason why gum disease may increase the risk of heart disease.
The link between gum and heart problems has long been recognised but it is unclear if poor oral health is simply a marker of a person's general wellbeing.
UK and Irish experts now say bacteria enter the bloodstream via sore gums and deposit a clot-forming protein.
The findings are being presented at a meeting of the Society for General Microbiology.
Earlier this year a Scottish study of more than 11,000 people found people who did not brush their teeth twice a day were at increased risk of heart disease.
It backed up previous findings suggesting a link, but researchers stressed the nature of the relationship still needed further analysis.
Protective platelets
Scientists from the University of Bristol working with the Royal College of Surgeons in Ireland now suggest it is the Streptococcus bacteria - responsible for causing tooth plaque and gum disease - which may be to blame.
Their work shows this bacteria, once let loose in the bloodstream, makes a protein known as PadA which forces platelets in the blood to stick together and clot.
Research such as this makes a welcome contribution to further understanding the nature of the relationship between gum disease and heart disease”
Prof Damian Walmsley
British Dental Association
"When the platelets clump together they completely encase the bacteria.
"This provides a protective cover not only from the immune system, but also from antibiotics that might be used to treat infection," said Professor Howard Jenkinson, who led the research.
"Unfortunately, as well as helping out the bacteria, platelet clumping can cause small blood clots, growths on the heart valves, or inflammation of blood vessels that can block the blood supply to the heart and brain."
While maintaining good dental hygiene could minimise the risk, the team is also investigating how the platelet-activating function of the protein PadA can be blocked.
Professor Damian Walmsley, scientific adviser to the British Dental Association, said: "Research such as this makes a welcome contribution to further understanding the nature of the relationship between gum disease and heart disease.
"It also underlines the high importance of brushing twice a day with fluoride toothpaste, restricting your intake of sugary foods and drinks and visiting the dentist regularly in order to maintain good oral health."
The British Heart Foundation said that were other factors besides oral health which had a greater impact on heart health.
But their senior cardiac nurse Cathy Ross added that combining good oral health care "with a healthy diet, not smoking and taking part in plenty of physical activity will go a long way in helping you reduce your overall risk of heart disease".
Source: BBC
| | Drinking a glass of milk can stop garlic breath Mon 6th September 2010 | If you are worried about garlic breath, drink a glass of milk, say scientists who claim it can stop the lingering odour.
In tests with raw and cooked cloves, milk "significantly reduced" levels of the sulphur compounds that give garlic its flavour and pungent smell.
The authors told the Journal of Food Science it is the water and fat in milk that deodorises the breath.
For optimum effect, sip the milk as you eat the garlic, they say.
Mixing milk with garlic in the mouth before swallowing had a higher odour neutralising effect than drinking milk after eating the garlic in the trial.
And full-fat milk provided better results than skimmed milk or just water, according to breath samples taken from a volunteer.
One of the compounds milk counteracts is allyl methyl sulphide or AMS.
This cannot be broken down in the gut during digestion, and so it is released from the body in the breath and sweat.
Although garlic is good for you - containing several vitamins and minerals - once eaten, it can cause bad breath and body odour lasting hours or even days.
Plain water, and some foods, such as mushrooms and basil, may also help neutralise garlic smells, the study authors Sheryl Barringer and Areerat Hansanugrum say.
But it is the mixture of fat and water together that works best, the Ohio State University team say.
"The results suggest that drinking beverages or foods with higher water and/or fat content such as milk may help reduce the malodorous odour in breath after consumption of garlic and mask the garlic flavour during eating," they say.
Source: BBC
| | Medieval diet aids healthy eating message Mon 6th September 2010 | Food historian Caroline Yeldham says the medieval diet was largely a heathy one.
The Horrible Histories series has been a great success in teaching children about the lives of the Romans, Aztecs and Egyptians, among others.
But could history also hold the key to encouraging our children to eat better?
Dr Iona McCleery, a lecturer in medieval history at Leeds University, believes it could help experts tackle the growing childhood obesity problem.
Armed with plastic skeletons, Iona and her team - who are funded by the Wellcome Trust - will be travelling round schools in the Wakefield area of Yorkshire, to teach about the effects of a medieval diet as part of the three-year "you are what you ate" project.
She said: "We will use history to develop a less preachy approach to modern health.
Snacking was much less socially acceptable so that is something we can learn from”
"We'll be asking questions such as 'how do our relatively low activity levels interact with our diet in contrast to soldiers and labourers of past times'?
"This project will completely transform public perceptions of the past. We'll be looking at things like how fruit and vegetables were at one time considered unhealthy and how we used to have a much spicier diet than we do now.
"Through food festival stalls and cooking demonstrations we will also reach people who don't usually go into museums to encourage them to think about how the past affects their own eating habits."
Peasant role models
Dr McCleery said that, whereas in the past it was the rich who risked weight gain, today poorer people are more more likely to become obese.
"Interestingly it was the peasant class, whose diet would class today as healthy," she said.
Neglect claim over child obesity
'Being fat at four means a life of ill-health'
"The poorer you were, the higher chances you ate more vegetables and had more mixed grains in your diet.
"The poor were semi-vegetarians who simply could not afford meat and social status. Wealth is very much associated with diet."
Food historian Caroline Yeldham agreed, saying that highlighting modern eating patterns and contrasting them to medieval diets would make people think about what they ate.
"The medieval diet was very fresh food. There were very few preserves so everything was made fresh and it was low in fat and low in salt and sugar."
Meal times were more a family and community focus in medieval times and Caroline said this was a positive force.
"Dining was very ritualised either in the family or household and was a formal activity. People were eating together regularly so although snacking was available, it was not a focus.
"Snacking was much less socially acceptable.
"There are certainly a much wider range of ingredients than we tend to eat today - more herbs and fish, rather than imports which were a small part of the diet and used as flavourings.
"There are some very famous people who became obese such as Henry VIII and Wolsey. But you did not see young people who were obese.
Most food in medieval times was seasonal.
"Medieval people were much more physically active than we are.
"They were like rugby players. When they were very fit and active they used up the calories, but after an injury or illness, that was when their activity level went down and they became obese.
Child health experts at Mend, a programme which aims to encourage obese children to be more healthy, praised the scheme.
"Being creative with food is a great way for children to learn about different foods," they said.
"Looking at what our medieval ancestors ate is an interesting way to get children to think about how their diets differ from their ancestors."
Source: BBC
| | Early day care may promote eczema development Sat 4th September 2010 | NEW YORK (Reuters Health) - Kids who spend their earliest years in day care may be at higher risk of eczema than kids cared for at home, according to a new study from Germany.
Eczema is a collective term for different skin conditions characterized by a scaly, itchy, reddish rash. From 10 percent to 20 percent of infants and children experience some symptoms of the disease, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
A number of studies have found that eczema is more common among East German than West German children, Dr. Claudia Cramer of the IUF-Institut fur Umweltmedizinische Forschung in Dusseldorf, Germany, and her colleagues write. Given that East German kids are also more likely to attend early day care, Cramer and her team investigated whether being in day care before age two, along with several other potential risk factors, influenced eczema risk.
The researchers followed 3,097 children from birth to age 6. Thirteen percent of the children from eastern Germany had been diagnosed with eczema by age 4, compared to 8 percent of the children from western Germany. Fifty-five percent of the children from East Germany attended day care in their first two years of life, compared to 6 percent of the West German children.
Early day care attendance was the only factor independently associated with eczema risk. Children in early day care were 56 percent more likely to have the skin condition than children who didn't attend day care before age 2. The effect seemed to weaken as children got older.
The difference in early day care is adequate to explain the differences between the two regions in eczema prevalence, Cramer and her team say.
While the study didn't look at why early day care could up eczema risk, the researchers say that in day care children may be exposed to more allergens and microorganisms than at home. Children in day care could also be more stressed, which could promote the development of eczema.
Future research should look into how different types of day care and the amount of time children spend in day care affects children's immune response and stress levels, the researchers conclude.
SOURCE: http://link.reuters.com/nac49n Allergy, published online August 17, 2010.
| | Reading Arabic 'hard for brain' Sat 4th September 2010 | Israeli scientists believe they have identified why Arabic is particularly hard to learn to read.
The University of Haifa team say people use both sides of their brain when they begin reading a language - but when learning Arabic this is wasting effort.
The detail of Arabic characters means students should use only the left side of their brain because that side is better at distinguishing detail.
The findings from the study of 40 people are reported in Neuropsychology.
When someone learns to read Arabic they have to work out which letters are which, and which ones go with which sounds.
It is the ability to tell letters apart that seems to work differently in Arabic - because telling the characters apart involves looking at very small details such as the placement of dots.
Professor Zohar Eviatar, who led the research team, said: "The particular characteristics of Arabic make it hard for the right hemisphere to be involved. When you are starting something new, there is a lot of [right hemisphere] involvement."
Clearer differences
The researchers looked at 40 university students. Some of the students only spoke Hebrew, while some also spoke and read Arabic well.
In order to work out which side of the brain reads letters, the researchers flashed letters for a 10th of a second to one side of a screen or the other.
When the eyes see something for just a short time, and it is at one side of a screen, only one brain hemisphere is quick enough to process the image.
The team measured how fast and how accurate the students were when they tried to tell letters apart, first in Hebrew and then in Arabic.
All the students could read Hebrew well, and they all used both left and right hemispheres to tell Hebrew letters apart.
The same thing has previously been found with English letters.
Characters in English and Hebrew are easier to tell apart because there are clearer differences between them than there are in Arabic.
Sensitivity
When they looked at the students' reading of Arabic letters it gave the team a clue about why children find the language difficult to learn to read.
The Hebrew-only speakers behaved like children just starting to read most languages - they tried to tell Arabic letters apart, managed to do it slowly but made a lot of mistakes, and used both hemispheres of their brains.
The good Arabic readers, however, only used their left hemispheres to tell Arabic letters apart.
The researchers were intrigued by this and investigated further. They wanted to know why the right hemisphere was not working when reading Arabic letters, so they set a right hemisphere challenge.
They showed the students pairs of extremely similar Arabic letters - with just "local" differences - and letters that are more different - with "global" differences.
When the Arabic readers saw similar letters with their right hemispheres, they answered randomly - they could not tell them apart at all.
"The right hemisphere is more sensitive to the global aspects of what it's looking at, while the left hemisphere is more sensitive to the local features," says Professor Eviatar.
The team think this may give them some clues about what readers may be doing wrong when they begin to try to read Arabic.
Reading hope
Both young children and adults call on both hemispheres to help them learn a new task.
And using both hemispheres is the right thing to do when reading English or Hebrew - so children's learning strategies would be fine if they were reading another language.
But previous research has found that the right hemisphere is not that good at distinguishing small details, so readers starting to learn Arabic have to learn to focus on small details, which is not natural to them, but could help them shift to their left hemispheres.
Now the researchers want to compare new and highly expert Arabic readers in the hope of finding out what their brains are doing when they look at letters.
Ultimately, they would like to work out how to teach Arabic reading better to children, including helping them to tell letters apart and how to remember which sound goes with which letter.
Source: BBC
| | Garden of Death: Man Survives Freak Infection Sat 4th September 2010 | In an unlikely twist, a man's love of gardening leads to Legionnaires' disease.
Pity the poor British fellow who learned that puttering in the garden can be, in rare instances, hazardous to one's health.
Researchers have published a case report involving a 67-year-old man admitted to a hospital in March after spending eight days suffering from fever, shortness of breath and confusion. The doctors' diagnosis was pneumonia, but they were at a loss to find the underlying cause, according to the report this week in The Lancet.
Initial tests came back negative for several pneumonia-causing viruses. But a fluid specimen taken from inside the man's lung cultured positive for a rare strain of Legionnaires' disease -- the potentially fatal and eponymous respiratory illness named for a 1976 outbreak among American Legion conventioneers in Philadelphia that sickened 221 people, including 34 who died. Legionella bacteria most often spread through tiny droplets of water spewed from cooling towers, hot tubs, showers or -- in the 1976 outbreak -- air conditioning systems. They do not spread from person-to-person.
In the British case, though, doctors were trying to figure out how a man who tinkers in the garden could become infected with typically airborne Legionella.
Further investigation revealed that the patient had cut his finger while composting two days before his symptoms began. Several published cases in Australia, New Zealand, Japan, the Netherlands, Switzerland and Scotland, as well as California, Oregon and Washington state, involved men and women who used compost mixes, compost heaps and potting mixes to plant tomatoes or bulbs, and contracted a strain called Legionella longbeachae, isolated in 1981 from a pneumonia patient in Long Beach, Calif. Subsequent tests in those cases confirmed the presence of Legionella in potting soils they handled.
Fortunately, the gardener responded to antibiotics. But the case has ongoing ramifications. The Royal Horticultural Society in Great Britain has issued warnings about the possibility of contracting Legionnaires' from touching compost and will begin posting cautionary advice on bags of potting compost.
Compost Key in Gardening-Linked Legionnaries' Disease Case
According to the federal Centers for Disease Control and Prevention in Atlanta, about 8,000 to 10,000 Americans are diagnosed with Legionnaires' each year. But that's widely considered to be the tip of the iceberg. "The number of cases is much higher since most of the time it is not looked for, the diagnosis is hard to make, and the usual antibiotic coverage for community-acquired pneumonia will take care of it," says Dr. Peter Katona, an infectious diseases specialist at UCLA.
Because it starts like many other types of pneumonia, with a high fever, chills and cough, it can easily elude proper diagnosis. Anywhere from 5 percent to 30 percent of cases end in death, but most sufferers recover with antibiotic treatment. The elderly, those with weakened immune systems, and people with lung disease are especially vulnerable.
A 2009 study published in the journal Clinical Microbiological Infection described potting soils as an important, but probably underestimated, source of Legionella infection, by L. longbeachae as well as other Legionella species associated with Legionnaires' disease. Katona says that the source of the bacterium -- either soil or water -- or the species isn't what determines how sick you can get. Instead, he says, it's "the magnitude of the exposure, the virulence of the bug, and the fact that it gets into both blood and lung as in this case."
And Legionnaires' disease isn't the only illness spread this way. Said Katona: "Soil and plant exposure also causes other diseases such as atypical mycobacteria and sporotrichosis." (Atypical myobacteria, which are in the same family as tuberculosis, cause a wide variety of infections, while sporotrichosis is a fungal skin infection).
Add to that list aspergillosis. In 2008, a 47-year-old British welder became sickened after opening bags of old gardening mulch that emitted a cloud of dust. That cloud proved toxic, as it contained spores of aspergillus, a common fungus that doesn't bother most people. But the welder who inhaled those spores developed aspergillosis, which landed him in an intensive care unit as his lungs shut down, and he died within days. Because of such mulch hazards, some doctors advise patients whose immune systems are weakened by chemotherapy, or immune-suppressing drugs, to stay out of their gardens.
Source: ABC News
| | Groups of friends key to changing health behaviors Fri 3rd September 2010 | CHICAGO (Reuters) - When it comes to changing health behaviors, it takes more than a far-flung network of friends on Facebook egging you on. It takes a jostling herd, U.S. researchers said on Thursday.
Social scientists have assumed that changing behavior would spread like the flu, which transmits best via individuals with lots of long-distance contacts.
But to change behavior, you need to be surrounded by the message -- with neighbors, family and members in the community all reinforcing the same idea.
"For about 35 years, wisdom in the social sciences has been that the more long ties there are in a network, the faster a thing will spread," Dan Centola of the Massachusetts Institute of Technology, whose study appears in the journal Science, said in a statement.
"It's startling to see that this is not always the case."
Knowing how best to influence health behavior is important to health reform as the United States turns its focus to preventing disease, rather than treating it.
Researchers have already shown that networks of friends can have a powerful impact on health behavior, influencing smoking, obesity and even happiness.
But it is not clear which type of network is best.
SOCIAL PETRI DISH
Centola set up two different types of social networks within an online community of about 1,500 people.
"I had to create a little social petri dish," Centola said in a telephone interview.
One group consisted of individuals with far-flung ties, and the other involved clusters of people who interacted with each other.
"When people signed up, I would assign them 'health buddies' in the space of this online social networking site," Centola said. To form friendship groups, Centola introduced people to six other people who had similar interests.
"That is the social world that you had," he said.
The goal was to get people to register for a health forum in which they rated different health services.
The team then seeded the groups with people to encourage them to sign up, and they watched to see how quickly people would register.
People in the small friend groups registered four times as fast as those with less connected networks.
"It spread through the population so quickly. It saturates very, very fast," Centola said.
Social scientists had thought that it would be redundant to give a health message to a person more than once. But Centola said when it comes to health habits, people are quicker to change when they hear the message from more than one source.
He said the findings are useful when policymakers need to develop strategies to promote vaccinations or health screenings, but it could be equally effective in combating obesity.
"The more difficult the behavior and the more resistant to change, the more vital these densely clustered ties would be," Centola said.
Source: Reuters
| | Diabetes drug might fight cancer Fri 3rd September 2010 | In use for years, metformin has few side effects
An ancient herbal remedy that constitutes the active ingredient in a modern diabetes drug may soon play a new role in combating cancer, two studies show. The findings, published in the September Cancer Prevention Research, support earlier population studies suggesting that diabetes patients receiving the drug, called metformin, are less prone to develop cancer.
Metformin helps to stabilize blood sugar by decreasing the liver’s glucose output and increasing the sugar’s use by muscle tissue. Scott Lippman, an oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, estimates that more than 40 million metformin prescriptions have been filled in the United States. “It’s been around for a while,” he says.
In one of the new studies, Atsushi Nakajima of Yokohama City University School of Medicine in Japan and colleagues measured how metformin affected the development of tiny lesions in the colon. These lesions, called aberrant crypt foci, are precursors of polyps, which themselves can be the forerunners of colon cancer. Using colonoscopy data, the scientists identified 26 patients who had had polyps removed during a colonoscopy. The scientists randomly assigned some to get metformin and others to get a placebo.
After a month, the nine patients getting metformin who returned for a follow-up colonoscopy had substantially fewer lesions in the bowel than they had when they started on the drug, whereas 14 patients receiving a placebo had no change.
In the other study, a U.S. team induced lung cancer in mice with injections of a tobacco-based carcinogen. One week after the last shot, some mice were given either a low or a medium dose of metformin in their drinking water for 13 weeks. The tumor burden in these mice declined by 39 percent and 53 percent over that time, depending on the dose they received.
When the researchers delivered an even higher dose of metformin, this time by injection, the tumor burden shrank by 72 percent, says study coauthor Phillip Dennis of the National Cancer Institute in Bethesda, Md.
Metformin is a drug in the biguanide class. The drug is derived from the French lilac plant (Galega officinalis), also known as goat’s rue or Italian fitch. In medieval Europe the plant was used to treat frequent urination, says Michael Pollak, an oncologist at McGill University in Montreal. Modern-era scientists took an interest in the biguanides in the 1920s, and found they could use the compounds to lower blood sugar in rabbits.
Metformin was derived from the plant in the 1950s in France and was approved by the U.S. Food and Drug Administration in 1994 as Glucophage (literally “glucose eater”). The drug has since become generically available under the name metformin.
A history of use with few side effects may help metformin as it faces regulatory hurdles to become a cancer fighter, Lippman says. “A lot is known about the safety of this,” he says. “From a research perspective, this is extremely exciting. The next step will be to take it to a clinical trial.”
Less clear is the mechanism by which metformin seems to inhibit cancer, and which cancers would be most susceptible if it succeeds. Earlier, Pollak’s team had shown that metformin could inhibit growth of breast cancer cells in a lab dish by awakening an enzyme called AMPK. The group further found that revved-up AMPK inhibits the activity of mTOR — a protein involved in cell growth and proliferation. That could explain part of metformin’s apparent anticancer effect, Pollak says. But, he adds, “We are not yet in a position where we understand perfectly how it works.”
The cancer connection didn’t come out of the blue. In recent years, several population studies have noted that type 2 diabetes patients on metformin seem less likely than others to develop cancer.
Source: Science News
| | Puzzles and crosswords delay dementia, study suggests Fri 3rd September 2010 | People who do puzzles and crosswords may stave off dementia longer but experience a more rapid decline once the disease sets in, a study suggests.
While there has long been speculation that "exercising" your brain could protect against Alzheimer's, there has been little evidence to back this up.
Now US researchers who followed more than 1,000 people suggest the more mentally active may delay the disease.
But once symptoms appeared, decline was quicker, the research suggested.
The team from the Rush University Medical Center in Chicago recruited 1,157 people aged over 65 in the early 1990s.
They were given a maximum of five points based on how often they engaged in a variety of activities which involved processing information, including listening to the radio or watching TV, reading a book, carrying out a crossword puzzle or jigsaw, or going to a museum.
Slowing down, speeding up
They were then followed for an average of 12 years, with assessments every three years.
For each additional point those without a diagnosed cognitive impairment saw a 50% slower decline in their brain function, which was examined through a variety of tests.
But the 148 people who had a diagnosis of Alzheimer's saw a 42% faster decline for each point they had accumulated for mental activity.
Writing in the journal Neurology, the authors suggest that cognitive activity enhances the brain's ability to maintain normal function as disease develops, allowing the mind to tolerate significant pathological changes without compromising its performance.
But when Alzheimer's is finally diagnosed, the disease appears to be at a more advanced stage.
"In effect, these results suggest that the benefit of delaying the initial appearance of cognitive impairment comes at the cost of more rapid dementia progression," says study author Dr Robert Wilson.
It does however, he added "reduce the overall amount of time that a person may suffer from dementia".
The Alzheimer's Society said this was a "robust study" which added considerable weight to the argument that, at least in later life, activities like puzzles could keep the brain ticking over for longer.
"However although the symptoms are delayed, there is no evidence changes in the brain associated with dementia have been reduced," a spokesperson said.
"That the brain is allowed to deteriorate to a larger degree before symptoms like memory loss become apparent could explain why the condition seems to progress more quickly after diagnosis.
"More research is now needed to establish why this happens and what role mental stimulation may have in keeping people functioning for longer.'"
Source: BBC
| | Homeopathy Shake-Up Goes Global Thu 2nd September 2010 | When is a sugar pill deadly? When it is substituted for real medicine, the Japanese public has come to understand.
The Japanese government is investigating numerous deaths that occurred over the past year resulting from the practice of homeopathy, which has been growing in popularity, particularly among midwives. Several lawsuits are pending.
Deaths include a 2-month-old baby girl born with a vitamin K deficiency, whose mother's midwife administered a homeopathic treatment instead of the much-needed vitamin K injection, well-known to prevent hemorrhaging. The infant died from bleeding in the skull.
As more cases surface, the nation's top science group, the Science Council of Japan, has weighed in, with its president, Ichiro Kanazawa, stating at a press conference on Aug. 24 that "homeopathy's therapeutic value has been scientifically and utterly disproved." Homeopathy treatments are nothing more than sugar pills, he said.
Japan may soon join Switzerland and Germany, where governments have concluded that homeopathy is ineffective; national health insurance no longer reimburses for homeopathic treatments there. (Ironically, homeopathy originated in Germany 200 years ago.)
Other European nations might follow suit, too. After a scathing report on homeopathy by the U.K. House of Commons Science and Technology Committee in February 2010, the British Medical Association this August called upon the U.K. National Health Service to refuse payments for homeopathy, to eliminate funding for homeopathic hospitals, and to otherwise instruct doctors to not prescribe, refer, or recommend homeopathy to patients.
Natural or supernatural
Is this big medicine beating up the little herbal practitioner? Not at all. The biggest misconception is that homeopathy is herbal medicine. Herbs have therapeutic value. Homeopathy, however, is devoid of herbs or anything medicinal.
Homeopathic medicines might start with an herb or mineral.
Oscillococcinum, the top homeopathic flu remedy, starts with duck liver. Remedies are diluted in 10- or 100-parts water over and over again, based on centuries' old recipes, until there is no longer any original ingredient.
So, the second biggest misconception is that homeopathic pills contain minute concentrations of medicine. Often the news media use the words "highly diluted" when in fact homeopathy is just highly delusional.
Oscillococcinum, for example, has a 200C concentration: One part duck offal was mixed with 100 ("C") parts water; this dilution was added to more water at a 1-to-100 ratio; and the process was repeated another 199 times. In the end, there is one part duck in 100 to the 200th power (or 1 followed by 400 zeroes) parts water.
You are left with simply water. Even the more "concentrated" homeopathic medicines — 24X, or 10 to the 24th parts water— amount to a pinch of medicine sprinkled in the Atlantic Ocean.
Homeopathic practitioners don't deny this little discord with physics.
Homeopathy was developed before the troublesome concepts of atoms and molecules. The argument now is that the homeopathic solutions coated upon sugar pills remember the shape of the medicine they once contained.
Alas, this too violates reality. A water molecule's shape is distorted by other molecules for mere picoseconds before settling back to normal; there's no water memory. If this were the case, all water on the planet would be a homeopathic treatment for every ailment, because it once touched every herb, mineral, or animal liver in the homeopathy canon.
You have a homeopathic treatment for food poisoning (arsenic at 24X) coming out of your faucet, provided you cut it a few times with pure water.
Proof or placebo
Plenty of studies show how homeopathy can work; many show how prayer or psychic distance healing can work, too. Homeopathy is rather effective for ailments that go away on their own, such as diarrhea and colds.
As documented in the February House of Commons report, homeopathy is shown to be less and less effective as studies get better and better. This same sentiment has been supported by thorough analyses by doctors in Switzerland and Germany and, for that matter, by the U.S. National Center for Complementary and Alternative Medicine, once led by a homeopath, which concludes there's little evidence to support homeopathy for anything.
Unlike many other fields of alternative medicine, dominated by quacks and frauds, homeopathy tends to attract intelligent health practitioners who truly believe in the efficacy of the treatments. Maybe homeopathy is an effective placebo. In that case, if you want the sugar pills to work, forget you read this article.
But please, don't trust homeopathy for your baby.
Source: Livescience
| | 'Brisk walks' to prevent cancers Thu 2nd September 2010 | About 10,000 cases of breast and bowel cancer could be prevented each year in the UK if people did more brisk walking, claim experts.
The World Cancer Research Fund scientists say any moderate activity that makes the heart beat faster should achieve the same.
For example, data suggest 45 minutes a day of moderate exercise could prevent about 5,500 cases of breast cancer.
Physical exercise helps prevent obesity, which is a cancer risk factor.
The WCRF team stress in their report that it is the total time spent being active that is important. You do not need to set aside half an hour each day to exercise. Shorter bouts of activity will be just as beneficial as long as they add up to the same, the charity says.
Alongside brisk walking, other activities that would count include cycling or swimming at a leisurely pace, dancing, gardening and vacuuming combined with other housework, says the WCRF.
Their head of science, Dr Rachel Thompson, said by making small changes to their daily routine people could achieve significant health gains.
"There is now every strong evidence that being physically active is important for cancer prevention.
"Even relatively modest increases in activity levels could prevent thousands of cancer cases in the UK every year.
"These figures also show you do not have to go to the gym every day to benefit.
"You can reduce your cancer risk just by making small changes and this is highlighted by the fact that so many cancer cases could be prevented through something as simple as brisk walking.
"By taking up walking as a hobby or even walking to the shops instead of taking the bus or car, people can make a real difference to their health."
Henry Scowcroft, science information manager at Cancer Research UK, said:
"You don't have to be an athlete to reduce your cancer risk.
"There's solid evidence that certain cancers - including breast and bowel cancer - are less common in people who do regular, moderate exercise such as brisk walking."
Source: BBC
| | Medicine errors 'could harm children' Wed 1st September 2010 | Many parents are incapable of giving their children the correct dose of liquid medicines, claim Australian researchers.
Using household spoons to measure them out could mean a potentially dangerous overdose, they say.
Children under five are at the highest risk of accidental overdose.
The study, presented in Lisbon, tested 97 adults and found 61% measured the wrong dose - 17% measured an overdose and 44% did not give enough.
Dr Rebekah Moles, from the University of Sydney, recruited 97 people visiting day-care centres catering for under-fives from the city.
Of these, 53 were mothers, seven were fathers and the rest were day care staff.
The researchers quizzed the adults on a number of scenarios, asking them what they would do next.
For example they told the parent that their youngest child felt hot and irritable, but was still drinking, eating and playing.
Common over-the-counter medicines were made available, together with a selection of spoons and other dosing devices, and the volunteers chose at what point they would use a medicine, and measured out the dose themselves.
Dr Moles said: "Taking all the scenarios together, 61% of the participants would have given an incorrect dose, and only 75% were able to measure accurately what dose they intended to give."
In total, 17% measured out an overdose of the drug, and 44% did not give enough.
"We found that 7% would give a medicine without taking their child's temperature, and 46% would give medicine when the temperature was less than 38 degrees."
In total, only 14% managed the scenario correctly.
Secret shoppers
Dr Moles said that almost half of the 119,000 calls received by the New South Wales Poisons Information Centre, which handles emergency calls from across Australia, concerned accidental overdose in children, with 15% needing hospitalisation.
The vast majority of the calls about children involved under-fives, she said.
Presenting her findings at the annual conference of the International Pharmaceutical Federation in Lisbon, she said: "We were surprised and concerned to find that some people thought that medicines must be safe because you can buy them without prescription.
"For example, one parent said to us that if Panadol (a paracetamol-based painkiller) is available over-the-counter, administering a double dose couldn't do any harm."
She said: "There is an urgent need to review the use of children's over-the-counter medicines by parents.
"We are following up this research by using mystery shoppers to visit pharmacies and see what advice they are given when presenting similar scenarios."
Neal Patel from the Royal Pharmaceutical Society of Great Britain, said that it was important for parents to give their child the correct dose.
He said: "If parents are unsure about dosing for children they should always consult the packaging information or seek advice from their local pharmacist."
"Medicines are always supplied in child-proof containers and parents can also help prevent accidental overdose by always keeping medicines out of the sight and reach of children"
Margaret Peycke, from the National Pharmacy Association, said: "Whether you are in Australia or the UK, medicines that are available to buy are safe if used correctly but there are some risks if they are not.
"The medicine should be administered carefully using the spoon or measuring device supplied, to ensure the child does not receive more or less than the recommended dose.
"Household spoons should not be used as a substitute as they do not measure amounts accurately unlike ones that come with the medicine."
Research at John Moores University in Liverpool, also to be presented at a conference this week, concluded that it was feasible to produce "mini-tablets", small enough for a younger child to swallow.
Source: BBC
| | J.K. Rowling Gives £10 million for MS Centre Wed 1st September 2010 | Author J.K. Rowling has given $15.4 million (10 million) to set up a clinic to treat and research multiple sclerosis, the disease that killed her mother.
The creator of boy wizard Harry Potter said Tuesday that the Anne Rowling Regenerative Neurology Clinic, named after her mother, will be based at the University of Edinburgh in Scotland. It will also study other degenerative neurological conditions, including Alzheimer's and Parkinson's disease.
Rowling said she hopes the clinic will become "a world center for excellence in the field of regenerative neurology."
Multiple sclerosis affects about 100,000 people in Britain, and Scotland has one of the world's highest rates of the disease. Its causes are not fully understood, although both genetics and environmental factors are thought to play a part. The university said Rowling's gift is the largest single donation it has received.
Rowling is a longtime resident of the Scottish capital, and began writing the Harry Potter books when she was a cash-strapped single mother in the city. "Edinburgh has given me so very much that I have been looking for a way to give something meaningful back to the city for a long time,"
Rowling said in a statement. "I cannot think of anything more important, or of more lasting value, than to help the university attract world-class minds in the field of neuroregeneration, to build on its long and illustrious history of medical research and, ultimately, to seek a cure for a very Scottish disease."
Rowling's mother died from complications related to MS in 1990, before the writer struck fame with her novels about the orphaned wizard. She has said her mother's death influenced one of the series' main themes - a child dealing with loss. Rowling recently turned 45, the age her mother was when she died. "I know that she would rather have had her name on this clinic than on any statue, flower garden or commemorative plaque, so this donation is on her behalf, too; and in gratitude for everything she gave me in her far-too-short life,"
Rowling said. The seven Harry Potter books have sold more than 400 million copies and spawned a hit movie franchise and a theme park. Forbes magazine has ranked Rowling as one of the richest women in Britain, with an estimated wealth of $1 billion.
Source: CBS News
| | Low Vitamin D Linked to Heart Failure Deaths Wed 1st September 2010 | Study Also Shows Higher Risk of Hospitalization for Heart Failure Patients With Low Vitamin D Levels
Low vitamin D levels are associated with a higher risk of death and hospitalization in people with heart failure, researchers report.
The study doesn't prove that low vitamin D levels place patients at higher risk of dying. Even if the findings are confirmed, low levels of vitamin D may be a marker for some other damaging factor.
The hope is that vitamin D supplements may be able to improve outcomes among people with heart failure, but this still needs to be put to the test.
Vitamin D is best known for helping the body absorb calcium, which restores and strengthens bone, protecting against fracture. But more and more studies suggest that low vitamin D levels are associated with the risk for a host of diseases, including certain cancers and kidney disease.
After several small studies linked low levels of vitamin D to poor outcomes in people with heart failure, Dutch researchers, led by Licette Liu, BSc, of the University Medical Center in Groningen, Netherlands, decided to start a larger study of 548 patients hospitalized with this condition.
Vitamin D and Heart Failure Patients
Patients were divided into three groups depending on their blood levels of vitamin D: low (below 29.6 nanomoles per liter), intermediate (29.6 to 43.9 nanomoles per liter), and high (above 43.9 nanomoles per liter).
Over the 18 months of follow-up, 165 patients died and 142 were hospitalized again. Those patients with the lowest vitamin D levels were 30% more likely to be hospitalized again or die than people with the highest levels. The effect of vitamin D levels held even after accounting for other factors.
The findings were presented at the annual congress of the European Society of Cardiology.
Anti-inflammatory Effects
No one knows exactly why vitamin D may help heart health.
But it may have anti-inflammatory effects that may help keep blood vessels healthy, Liu says.
In the study, low levels of the vitamin were associated with high levels of C-reactive protein (CRP), a measure of inflammation activity.
This study was not designed to show whether supplementing heart failure patients with vitamin D would improve prognosis or even if it was safe to do. Until vitamin D pills are proven to improve outcomes among people with heart failure who have a deficiency, patients should not take supplements unless prescribed by a doctor, says American Heart Association past president Clyde Yancy, MD, medical director of the Baylor Heart and Vascular Institute at Baylor University Medical Center in Dallas.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
| | Half of Britons get sunburnt Wed 1st September 2010 | Almost half of people got sunburnt this summer and many would be willing to risk it again in their search for a tan, a survey has suggested.
Some 46 per cent of people questioned got burnt over the holiday months, with 32 per cent of those saying they had been trying to get a tan.
Even though burning increases the risk of skin cancer and can produce ill effects such as sunstroke and blistered skin, many people find the risk worthwhile, the poll of 2,000 people showed.
More than one in three of those who were sunburnt said they would be a bit more careful next year but would still go out in the hope of getting a tan.
Ed Yong, head of health information at Cancer Research UK, said: "Sunburn is a clear sign that your skin has been damaged in ways that can lead to skin cancer, a disease that's affecting more and more people in the UK.
"While it's important to enjoy the sun safely to get enough vitamin D, there are risks involved in long exposures. And these results indicate that people aren't taking these risks seriously enough."
Source: ITN
| | Pot may provide some chronic pain relief: study Tue 31st August 2010 | NEW YORK (Reuters Health) - In a small study, people who had chronic pain as a result of damage to the nervous system reported feeling less pain, as well as less depression and anxiety, when they smoked marijuana compared to when they smoked a drug-free placebo.
The pain reduction was "modest" - less than 1 point on an 11-point scale for the strongest marijuana - and patients reported no overall difference in their quality of life based on what they smoked.
The results support a limited number of trials that have suggested marijuana may be helpful for people suffering from chronic pain, but that it also has its limitations.
"This offers another potential tool in the tool box for treating chronic neuropathic pain," Dr. Mark Ware, a neuroscientist at the McGill University Health Center in Montreal and the study's lead author, told Reuters Health. But there are still questions about marijuana's long-term safety as a pain reliever, he said.
Ware and his colleagues recruited 21 adults who were suffering from chronic neuropathic pain after an injury or surgery. Three times a day, for five days, participants took a 25 milligram hit of one of four treatments: marijuana that was 2.5 percent, 6 percent, or 9.4 percent tetrahydrocannabinol (THC) or a 0 percent placebo. All patients rotated in random order through the four different treatments, with a nine-day break between each one.
During each treatment, participants were asked about their pain, sleep patterns, mood, and overall quality of life.
Patients smoking 9.4 percent THC marijuana reported lower pain scores than when smoking the placebo - on average, 5.4 versus 6.1 on a scale from 0 ("no pain") to 10 ("worst possible pain"). They also reported that they slept better, and were less anxious and depressed than when they were on the placebo.
When smoking marijuana with moderate doses of THC, participants generally reported improved symptoms, but there was no significant difference in their relief from these doses compared to relief from the placebo treatment. There was also no difference in the quality of life or mood scores that participants reported when they were on any of the four treatments.
The highest dose of THC produced the most side effects, which included headaches, dry eyes, and a burning sensation in the regions where patients had pain.
In the second, third and fourth rounds of treatment, most - but not all - patients were able to tell when they had been on either the highest THC dose or the placebo. Most patients did not report feeling "high" at any point during the study.
About 1 to 2 percent of adults in the U.S. suffer from chronic neuropathic pain - pain that occurs when nerve fibers are damaged by injury or disease, and lingers even after the original wound has healed. The condition is treated with a range of different medications, including drugs usually intended for people with depression and epilepsy. But these don't work for all patients, and some also have uncomfortable side effects.
"A lot of the treatments that are used for neuropathic pain ...might also be associated with disruptions in sleep," Dr. Andrea Hohmann, who studies marijuana and pain at the University of Georgia and was not involved with the current study, told Reuters Health. For that reason, the finding that marijuana may actually help improve patients' sleep, she said, is "particularly noteworthy."
The cannabinoid family, which includes marijuana, is "emerging as an interesting new class of drugs for pain management," Ware said. But, "we also know that treating chronic pain of any kind requires more than just (drugs)," he said. No matter what kind of medication they're on, these patients should also be getting behavioral and physical therapy, he said.
The study's five-day treatment sessions also leave questions about patients with chronic conditions who might need treatment for months or years. "The trial did not last long ... so the authors cannot really say whether any response would be sustained," Dr. Henry McQuay, who studies pain and pain relief at the University of Oxford, wrote in an editorial accompanying the study.
Ware agreed that more research is needed. "What about long-term safety issues?" he asked. "These need to be considered before the drug becomes prescribable."
SOURCE: http://link.reuters.com/pyd77n Canadian Medical Association Journal, online August 30, 2010.
| | Study finds first genetic link to common migraine Tue 31st August 2010 | LONDON (Reuters) - An international scientific team has identified for the first time a genetic risk factor associated with common migraines and say their research could open the way for new treatments to prevent migraine attacks.
Researchers who looked at genetic data from 50,000 people from Finland, Germany and The Netherlands found that patients with a certain DNA variant affecting regulation of a particular brain chemical have a greater risk of developing migraines.
The results suggest that a buildup of that chemical, called glutamate, may play a role in the mechanism of migraines.
"This is the first time we have been able to peer into the genomes of many thousands of people and find genetic clues to understand common migraine," said Aarno Palotie, chair of the international headache genetics consortium at the Wellcome Trust Sanger Institute in Britain, which led the study.
Migraine affects around one in six women and one in 12 men, and has been estimated to be the most expensive brain disorder to society in the European Union and the United States.
Not only is migraine painful, it also can be disabling and is often a life-long condition. The World Health Organization ranks it 19th among all causes of "years lived with disability," and family life, social life and work capacity are negatively affected in almost all migraine sufferers.
Global sales of drugs to treat migraine were around $2.6 billion in 2009, according to analysts at Deutsche Bank.
GlaxoSmithKline's Imitrex, Merck's' Maxalt, AstraZeneca's
Zomig and Pfizer's Relpax are among leading medicines currently on the market for migraine, but the exact causes of the condition remain unknown.
In a study published in the journal Nature on Sunday, Palotie's team said the particular migraine risk DNA variant they had identified was on chromosome 8 between two genes known as PGCP and MTDH/AEG-1.
Their research showed that it appears to regulate levels of glutamate, a chemical known as a neurotransmitter which transports messages between nerve cells in the brain.
It does this by altering the activity of MTDH/AEG-1 in cells, which regulates the activity of the EAAT2 gene -- a protein responsible for clearing glutamate from brain synapses.
Previous research has found links between EAAT2 and other neurological diseases, including epilepsy, schizophrenia and various mood and anxiety disorders.
"Until now, no genetic link has been identified to suggest that glutamate accumulation in the brain could play a role in common migraine," Christian Kubisch of University of Ulm in Germany, who also worked on the study, said in a statement.
"This research opens the door for new studies to look in depth at the biology of the disease and how this alteration in particular may exert its effect."
The scientists said further research would be needed into the DNA variant, and into its effect on the genes around it, to find out more about how migraines occur. Further work was also needed to search for other possible genetic links, they said.
Source: Reuters
| | MS activity alters with seasons, US researchers say Tue 31st August 2010 | The severity of multiple sclerosis (MS) may change with the seasons, say US researchers.
Brain scans of patients compared with weather patterns at the time showed higher levels of disease activity in the spring and summer.
The US researchers said the findings had implications for testing new medicines, which may show up different results depending on the time of year.
It is not clear why warmer weather would have this effect.
Other studies have shown that vitamin D from exposure to sunlight may have a protective effect against MS - a long-term inflammatory condition of the central nervous system.
For the study, researchers compared MRI brain scans of 44 people taken from 1991 to 1993 to daily temperature, solar radiation and precipitation measurements over the same time.
The adults in the study, who had untreated MS, had eight weekly scans followed by eight scans every fortnight then six monthly check-ups - an average of 22 scans per person.
After one year, 310 new brain lesions were found in 31 people, they reported in Neurology.
The lesions were up to three times more likely to appear in the warmer spring and summer months.
Further analysis also showed that there was a link between both new disease activity and intensity of disease activity and the warmer months.
Trial results
Study leader Dr Dominik Meier, from Brigham and Women's Hospital in Boston, said: "Not only were more lesions found during the spring and summer seasons, our study also found that warmer temperatures and solar radiation were linked to disease activity."
He pointed out that clinical trials often use MRI (magnetic resonance imaging) to assess the effectiveness of a drug and studies commonly last between six and 12 months, which may have implications for how effective a new medication seems.
In an accompanying editorial Dr Anne Cross, from Washington University School of Medicine, added: "This is an important study because it analyses records from the early 1990s, before medications for relapsing MS were approved, so medicines likely could not affect the outcome.
"Future studies should further explore how and why environmental factors play a role in MS."
Dr Susan Kohlhaas, research communications officer at the MS Society, said more research was needed.
But added: "This small study is intriguing and, if validated in larger studies, has the potential to influence the way clinical trials are designed."
Source: BBC
| | Oesophageal cancer rates rise steeply in British men Sat 28th August 2010 | LONDON (Reuters) - Rates of esophageal cancer in men have risen by 50 percent in Britain in a generation, an increase that is probably being driven in part by growing rates of obesity and poor diet, scientists said on Saturday.
As the "fat man of Europe," Britain is seeing far higher rates of a type of esophageal cancer called adenocarcinoma, which is related to obesity and eating a high saturated fat diet, researchers with the charity Cancer Research UK said.
"We think the obesity epidemic may be a big reason behind the increase. We know that being overweight significantly increases the risk of adenocarcinoma -- the main type of esophageal cancer that's on the up," said Janusz Jankowski of Barts & The London School of Medicine & Dentistry, whose research was backed by the charity.
"Our changing diets are also likely to be influencing the rise, with people eating less fruit and vegetables."
In a telephone interview, Jankowski said adenocarcinoma rates in Britain were now among the highest in the world, including the United States, suggesting genetic factors, as well as obesity rates, may be having an influence.
"If you look at people who get this adenocarcinoma type of cancer, it seems to be mainly Anglo Saxon males," he said, whereas black populations appear to have lower rates.
Jankowski and colleagues are expecting to publish the results of research into the genetic factors that may be behind the causes of the disease within the next 6 months.
"Then we may have an answer on whether it is nature or nurture. I suspect it will be a combination, but the question is whether it is skewed one way or the other," he said.
The Cancer Research UK figures showed that while in 1983, 9.6 in every 100,000 men in Britain were diagnosed with esophageal cancer, now it is 14.4 -- an increase of 50 percent.
Lesley Walker, director of cancer information at the charity, said the figures were particularly worrying because esophageal cancer is very difficult to treat.
In Britain, only 8 percent of people with the disease survive at least five years.
Source: Reuters
| | Two vision correction techniques look comparable Sat 28th August 2010 | NEW YORK (Reuters Health) - Two forms of laser vision correction sometimes used as an alternative to LASIK seem to have similar results for people with nearsightedness, a new research analysis finds.
The findings, published in the journal Ophthalmology, confirm results from smaller studies suggesting that patients fare about as well with either of the procedures -- namely, photorefractive keratectomy (PRK) and LASEK, a relatively newer technique that differs from its much more common sound-alike LASIK.
Since it was introduced in the U.S. in the 1990s, LASIK has become by far the most commonly used surgical technique for correcting nearsightedness, farsightedness and astigmatism.
But PRK and LASEK are both options for people who cannot undergo LASIK because of certain factors, such as relatively thin corneas.
Like LASIK, the two procedures improve vision by using a laser to reshape the middle layer of the cornea, the transparent membrane that domes over the pupil. The basic difference among the three techniques is that they differ in how the outer layer of the cornea is managed.
With LASIK, the surgeon cuts away a thin "flap" of tissue to gain access to the middle layer of the cornea, and once the surgery is complete the flap is replaced. With PRK, which emerged in the 1980s, there is no flap; instead the top-most layer of the cornea is removed, then naturally regenerates after surgery.
LASEK, which has been in use for about a decade, combines elements of PRK and LASIK. As with the latter, the surgeon makes a flap of corneal tissue, but it's a thinner one, created using a microsurgical blade and an alcohol solution.
Compared with PRK, people who undergo standard LASIK tend to have less post-operative pain and shorter recovery times: with LASIK, patients often have good vision the next day, whereas with PRK, corneal healing typically takes a few days, and patients may need a week to have clear vision.
So in theory, LASEK could also have an advantage over PRK as far as recovery time and post-operative pain, according to the researchers on the new review, led by Dr. Li-Quan Zhao of Xinhua Hospital in Shanghai, China.
But in an analysis of a dozen studies since 2001, the researchers found that PRK- and LASEK-treated eyes showed no differences as far as vision improvement, postoperative pain or recovery time.
The studies included in the analysis were relatively small -- with all 12 involving a total of 542 patients. Ten of the studies were clinical trials in which patients had one eye randomly selected for treatment with PRK and the other with
LASEK.
When the researchers combined the studies' results, they found that both techniques carried a corneal healing time of about three to four days. And patients' postoperative pain ratings were similar for the PRK- and LASEK-treated eyes.
Vision improvements were similar as well. Across the six studies that reported the proportion of patients who came away with 20/20 vision or better, 197 of 320 PRK-treated eyes showed such an improvement; that compared with 204 of 314 LASEK-treated eyes -- a statistically insignificant difference. Most eyes ended up with at least 20/40 vision.
"This study basically confirms what most of us have thought," said Dr. James Salz, a clinical professor of ophthalmology at the University of Southern California, Los Angeles, and a spokesman for the American Academy of Ophthalmology.
When LASEK first came out, Salz noted in an interview, there was a lot of "hype" that it might rival LASIK.
The idea of combining elements of the PRK and LASIK procedures was that it might limit the downsides of the two -- such as the longer recovery time with PRK and the heightened risk of dry eyes with LASIK.
Instead, LASEK and PRK appear comparable, Salz said.
The one difference that emerged in the current study was that PRK-treated eyes had a greater risk of "corneal haze" in the first few months after surgery, though not by the sixth month. Corneal haze, where opaque cells form in the cornea, can interfere with visual acuity.
Salz pointed out, however, that the studies in this analysis involved older PRK techniques. More recent advances in the procedure appear to be reducing the risk of haze.
According to Salz, the bottom line for patients needing an alternative to LASIK is that PRK and LASEK are likely to produce similar results. They also have a similar price tag.
The costs of laser vision correction vary widely in the U.S. In an urban area where surgeons have a lot of overhead, Salz noted, LASIK might run about $2,000 to $2,500 per eye. PRK and LASEK would likely be several hundred less than that.
The procedures also carry many of the same potential side effects and downsides, such as problems with night vision that include glare and seeing "halos," and vision that is less sharp than what a patient previously had with corrective lenses.
For people interested in laser vision correction, choosing an experienced surgeon is key, regardless of the specific technique.
Salz suggested that prospective patients ask a local ophthalmologist who does not personally perform the procedures for recommendations on surgeons in their area.
SOURCE: http://link.reuters.com/guh77n Ophthalmology, online August 16, 2010.
| | Top eight cancer signs pinpointed Sat 28th August 2010 | The eight unexplained symptoms most closely linked to cancer have been highlighted by researchers.
The Keele University team also points to the age at which patients should be most concerned by the symptoms, which include blood in urine and anaemia.
The other symptoms are: rectal blood, coughing up blood, breast lump or mass, difficulty swallowing, post-menopausal bleeding and abnormal prostate tests.
Cancer Research UK said unusual changes in a person's health should be checked.
The researchers were looking for symptoms which gave a one in 20 or higher chance of turning out to be cancer.
Although this still represents a relatively low chance of anyone with the symptom having the disease, any suspicion of cancer can mean that the patient is sent for tests more quickly, in order to catch the disease as early as possible.
The figure for each symptom was calculated by combining the results of 25 previous studies.
They found that, if the patient was below the age of 55, there were only two signs which reached the 'one-in-20' threshold.
These were a rectal prostate examination which gave abnormal results, and a breast lump.
After 55, but only in men, there was evidence that difficulty swallowing could be a sign of oesophageal cancer, while blood in the urine was highlighted as a particular concern for men and women aged over 60.
'Not the only signs'
Dr Mark Shapley, who led the research, said: "GPs should audit their management and reflect upon these cases as part of their appraisal to improve quality of care.
"There should be more open public debate on the level of risk that triggers a recommendation for referral by a GP."
Professor Amanda Howe, honorary secretary of the Royal College of General Practitioners, said: "It's useful to see these well-known 'red flag' symptoms and signs validated in primary care research, and reinforces the importance of encouraging patients to discuss worrying symptoms early with their GP."
However, a spokesman for Cancer Research UK said that these were by no means the only potential warning signs for cancer.
"The particular symptoms this study has highlighted are already thought of as important potential signs of cancer, but there are more than 200 different types of cancer, which cause many different symptoms.
"So if you notice an unusual or persistent change in your body it's important to get it checked out. When cancer is diagnosed at an early stage, treatment is often more likely to be successful."
Source: BBC
| | Surgery for obesity increases 10-fold in England Fri 27th August 2010 | LONDON (Reuters) - Use of weight-loss surgery has increased 10-fold in hospitals in England since 2000 and those who have gastric bands fitted can reduce their risk of early death and cut health service costs, scientists said on Friday.
In a study published in the British Medical Journal, researchers said one reason for the rapid rise in weight-loss procedures, or bariatric surgery, was increased demand from obese patients as they become more aware of surgery as a viable treatment option.
Bariatric surgery is performed on people who are dangerously obese, as a way of trying to help them lose weight.
The idea is to reduce the size of the stomach, either with a gastric band or a gastric bypass that re-routes the small intestines to a small stomach pouch, or by removing a portion of the stomach.
A team of researchers based at Imperial College London analyzed data on weight-loss surgery for the NHS in England between April 2000 and March 2008 and found that a total of 6,953 bariatric procedures were carried during that time.
The number of operations rose more than 10-fold from 238 in 2000 to 2,543 in 2007, they said in a report of their findings.
Analyzing outcomes for patients at 30 months and one year after surgery, the researchers found that those who had gastric banding had lower post-surgery death rates and had to be readmitted to hospital less and for shorter times than patients who had gastric bypass operations.
The National Institute for Health and Clinical Excellence (NICE), which assesses the cost effectiveness of medical treatments for the NHS, recommends bariatric surgery for people with "morbid obesity."
This includes people with a body mass index (BMI) of at least 40, and those who have a BMI of at least 35 and are also suffering from other diseases that could be improved by weight loss.
BMI is equal to weight in kilograms divided by height in meters squared.
| | Older men's testosterone varies by country, race Fri 27th August 2010 | NEW YORK (Reuters Health) - New research shows older men's sex hormone levels depend on both race and geographical location, casting further doubt on the criteria for "male menopause."
More than a million testosterone prescriptions are being written in the U.S. every year, experts say, and many go to middle-aged and older men with stunted libido and depressed mood presumably caused by low levels of the male sex hormone.
But there is no consensus about what these symptoms -- sometimes called "male menopause" or "low T" -- mean, or when testosterone levels are too low in the first place. (See Reuters Health story of June 16, 2010: Doubts cast on "male menopause" criteria.)
In the new study, published in the Journal of Clinical Endocrinology & Metabolism, researchers measured sex hormones in more than 5,000 elderly men from five countries across the globe.
They found average testosterone levels varied by 18 percent, landing twice as many white Americans (6 percent) in the low range compared with men from Hong Kong and Japan.
Low testosterone, also called hypogonadism, has been linked to erectile dysfunction and poor libido.
According to Solvay Pharmaceuticals, which makes a prescription ointment for men with low testosterone, the hormone is considered low when it dips below 300 nanograms per deciliter of blood.
However, skeptics say the symptoms of low testosterone may really just be the symptoms of old age, and there is no agreement about how low the hormone has to go before it becomes a problem. (See Reuters Health story of June 8, 2010: Do you have 'Low T?' Or is it just hype?)
"International variation in sex (hormone) levels could have obvious implications for the diagnosis and treatment of hypogonadism," write the researchers on the new study, led by Dr. Eric Orwoll of the Oregon Health & Science University in Portland.
They say it is unclear why the hormone levels differ across the globe. At least part of the reason has to do with environmental factors such as diet, chemicals or social status, it appears, because Asian men who lived in the U.S. had testosterone levels similar to other Americans, while those who lived in Asia did not.
Testosterone wasn't the only hormone that varied. Black men in the U.S. and Tobago had higher levels of the female sex hormone estradiol, for instance, which has been tied to a lower risk of bone fractures.
"These results may have important health implications," the researchers write.
SOURCE: http://link.reuters.com/qef57n Journal of Clinical Endocrinology & Metabolism, online June 28, 2010.
| | Lifestyle changes curb overnight bathroom trips Fri 27th August 2010 | NEW YORK (Reuters Health) - If you're frequently bothered by waking in the middle of the night to empty your bladder, there may be some simple and drug-free lifestyle adjustments that can help, a small study suggests.
So-called "nocturia" is the complaint of getting up at least once a night to urinate -- either due to a heightened production of urine or the inability of the bladder to hold it, sometimes as a result of an underlying medical problem. The condition can contribute to fatigue and depression, and raise the risk of heart disease and gastrointestinal disorders.
However, as experts note, nocturia is also very normal, especially as people age. And not everyone affected is bothered by it.
The standard treatments for frequent nighttime urination include "medical therapy as well as lifestyle modifications such as fluid restrictions," senior researcher Dr. Koji Yoshimura of Kyoto University Graduate School of Medicine in Kyoto, Japan, told Reuters Health in an email. "However, the efficacy of the lifestyle therapy has not been established so far."
Yoshimura and his colleagues studied 56 people complaining of nocturia who were about 75 years old, on average. They tested the effects of four easy lifestyle changes: fluid restriction, limiting any excess hours in bed, moderate daily exercise and keeping warm while sleeping.
Each patient was advised of the benefits of each modification, including a recommendation to limit their fluid intake to about 2 percent of their body weight during the day -- avoiding too much in the evening. This translates to about one and a half quarts of water for a 165-pound person.
After four weeks, the participants' average number of nighttime bathroom trips dropped. More than half of the patients experienced an improvement of more than one episode a night, Yoshimura and colleagues report in The Journal of Urology. Total urine volume also decreased (from 923 to 768 milliliters).
Dr. Serge Marinkovic of St. Francis Hospital, in Indianapolis, who was not involved in the study, noted that the effectiveness of the lifestyle changes was comparable to that of drug interventions.
Current medication options for nocturia include a synthetic version of a hormone that keeps the body from making urine at night, a drug that blocks the ability of the bladder muscles to contract, and antidepressants that make it harder to urinate by increasing tension at the bladder neck, he told Reuters Health.
"None of these medications are a great cure, and all have side effects, including dry mouth, constipation and heartburn," Marinkovic said. "They're significant enough for up to 70 percent of patients to stop using the drug within 6 months."
A limitation of the current study, Marinkovic noted, is the fact that patients were not monitored to determine how well they actually adhered to each of the behavior modifications. Another limitation is the lack of an untreated control group, which means a placebo effect can't be ruled out.
In his practice, Marinkovic typically starts off with his nocturia patients by going over a medical history to rule out underlying conditions such as diabetes or renal problems. Then he has them keep a diary of fluid intake and nighttime symptoms, which helps him prescribe behavioral changes such as fluid restriction. On top of this, he often adds medications, he said.
But again, not everyone is bothered by frequent trips to the bathroom during the night, Marinkovic emphasized.
"I saw a guy two weeks ago who gets up four times a night, and it's not a problem for him," he said. "He told me he does some of his best thinking when he's walking to the bathroom."
SOURCE: http://link.reuters.com/nuc57n The Journal of Urology, September 2010.
| | Insulin resistance may cause Alzheimer plaques Thu 26th August 2010 | HONG KONG (Reuters) - People with insulin resistance and type 2 diabetes are more likely to develop plaques in the brain associated with Alzheimer's disease, researchers in Japan reported on Thursday.
The study involved 135 elderly participants in the town of Hisayama, Fukuoka prefecture, who had their blood sugar levels checked several times at the start of the study. They were then monitored for signs of Alzheimer's disease for 10 to 15 years.
After they died, researchers conducted autopsies on their brains and found plaques, particularly in those who had high blood sugar levels while they were alive.
"It is possible that adequate control of diabetes in midlife may contribute to ... prevention of Alzheimer's disease," wrote lead researcher Kensuke Sasaki at Kyushu University in Fukuoka in an email reply to Reuters.
Prevalence of type 2 diabetes and Alzheimer's disease are soaring around the world due to growing obesity and people living longer lives, but most healthcare systems are ill equipped to handle such chronic illnesses.
Twenty-one participants, or 16 percent, developed Alzheimer's disease before they died and plaques were found in all of their brains. But the autopsies also found plaques in other participants who had abnormally high blood sugar levels.
Plaques were found in 72 percent of people with insulin resistance and 62 percent of those with no indication of insulin resistance, the researchers wrote.
"The point is that insulin resistance may possibly accelerate plaque pathology (development)," Sasaki wrote.
Insulin resistance is the stage before diabetes and it occurs when insulin, a hormone in the body, becomes less effective in lowering blood sugar.
A few studies in the past explored the relationship between diabetes and Alzheimer's, but findings were inconsistent and it was never certain which was the cause and which the result.
But this study has the longest observation period so far and the researchers said it was more likely that insulin resistance or diabetes resulted in Alzheimer's disease.
Source: Reuters
| | Antihistamine use linked to extra pounds Thu 26th August 2010 | NEW YORK (Reuters Health) - People who use prescription antihistamines to relieve allergy symptoms may be more likely than non-users to carry excess pounds, a new study suggests, although the significance of the connection is not yet clear.
In a study of 867 U.S. adults, researchers at Yale University in New Haven, Connecticut, found that prescription antihistamine users were more likely to be overweight or obese than non-users were.
Among the 268 antihistamine users, 45 percent were overweight, versus 30 percent of the 599 study participants not on the medications.
The researchers stress, however, that the findings do not prove that antihistamines are the cause of the extra pounds. This type of study, known as an observational study, can only point to an association between two variables -- in this case, antihistamine use and body weight -- and cannot prove cause-and-effect.
It's possible that some other factor explains the link, according to lead researcher Dr. Joseph Ratliff, a postdoctoral associate in Yale's department of psychiatry.
"There have been studies that show allergies and asthma themselves are associated with obesity," he told Reuters Health in an email, "so these conditions themselves may have an effect."
Still, in a report in the journal Obesity, Ratliff and his colleagues say the findings point to an important question for future studies to explore.
According to Ratliff, the researchers were interested in looking at the relationship between antihistamines and weight because of what's known about medications called atypical antipsychotics.
Those drugs -- such as olanzapine (Zyprexa) and risperidone (Risperdal) -- are used to treat schizophrenia and other mental illnesses and carry the side effect of weight gain. They also have antihistamine effects.
Histamine is a chemical produced in the body that is best known for its role in promoting the inflammation associated with allergic responses; blocking histamine is a good thing when it comes to relieving hay fever symptoms, for instance.
But cells throughout the brain have receptors for histamine, and the chemical appears to have a hand in a number of physiological functions -- with appetite control and calorie burning being among them.
So in theory, Ratliff explained, antihistamines could contribute to overeating and slower fat breakdown.
The current findings are based on 867 adults who took part in a government health survey in 2005 and 2006. All participants had their weight and height measured, as well as their blood sugar, cholesterol and levels of the blood-sugar-regulating hormone insulin.
On average, antihistamine users had a higher body mass index (BMI) -- at about 31, which falls into the category of obesity. That compared with a BMI of about 28 among non-users, which correlates to being moderately overweight. BMI is a standard measure of weight in relation to height used to gauge obesity.
When the researchers accounted for participants' age and sex, antihistamine use was linked to a 55 percent increase in the odds of being overweight versus non-use. The medications were not linked to higher odds of elevated blood sugar, insulin or cholesterol, however.
More studies are needed to see whether antihistamines do in fact have an effect on body weight.
The question is important, Ratliff and his colleagues note, as an estimated 50 million Americans have allergies, and anywhere from 35 percent to 50 percent of them use antihistamines.
For now, Ratliff recommended that people with allergies talk with their doctors about all the potential side effects of the different treatment options, and try to find one that works best for them.
Other allergy treatments include corticosteroid nasal sprays and eye drops, decongestants, cromolyn sodium nasal sprays and allergy shots. Non-drug tactics to managing allergies include limiting exposure to symptom triggers -- such as pollen, mold or pet dander -- and using salt-water nasal washes.
SOURCE: http://link.reuters.com/dyr27n Obesity, online August 12, 2010.
| | The 10 Healthiest Ethnic Cuisines Thu 26th August 2010 | It's dinnertime, and you're craving something with a little flavor. Maybe you'll grab Indian takeout or whip up a taco salad. But, uh-oh, these days it's easy to find yourself biting into the ethnic version of a triple burger and fries.
"We've Americanized dishes to the extent that they don't have their original health benefits," says Daphne Miller, M.D., author of "The Jungle Effect: The Healthiest Diets from Around the World -- Why They Work and How to Make Them Work for You."
Enjoy global cuisines in their purest state, on the other hand, and you get meals that are light, nutritious, and incredibly yummy. So we asked experts to rank the 10 healthiest cuisines and reveal what makes them good for you.
1. Greek
There's a good reason docs love the Mediterranean diet: Traditional Greek foods like dark leafy veggies, fresh fruit, high-fiber beans, lentils, grains, olive oil, and omega-3-rich fish deliver lots of immune-boosting and cancer-fighting ingredients that cut your risks of heart disease, diabetes, and other diet-related ailments.
In fact, eating a traditional Mediterranean-style diet is associated with a 25 percent reduced risk of death from heart disease and cancer, according to Harvard University research. And people lose more weight and feel more satisfied on this type of diet, which is rich in healthy fats, than on a traditional low-fat diet, another Harvard study suggests.
This cuisine also ranks high because of how it's eaten, says Miller, who is also an associate professor of family medicine at the University of California, San Francisco.
"The Greeks often share small plates of food called meze," she says, having just a bite of meat along with low-cal, healthy Greek staples like fresh seafood, slowly digested carbs (beans, eggplant, or whole-grain breads), and small portions of olives and nuts.
If you're eating out, order grilled fish and spinach or other greens sautéed with olive oil and garlic.
"This dish gives you the anti-inflammatory combo of olive oil and greens with the blood-pressure-lowering effects of garlic," Miller says.
Danger zone: Unless you make it yourself and go light on the butter, the classic spinach pie (spanakopita) can be as calorie- and fat-laden as a bacon cheeseburger.
2. California Fresh
You don't have to live on the West Coast to reap the body benefits of the California style of cooking. California Fresh is all about enjoying seasonal, local foods that are simply prepared -- and that's a healthy style you can adopt no matter where you live, says supermarket guru Phil Lempert, a leading consumer trend-watcher.
Eating plenty of disease-fighting, naturally low-cal, nutrient-rich fruits and vegetables from a local farmers' market or farm is good for your body, and it's satisfying, says Frances Largeman-Roth, R.D., Health magazine's senior food and nutrition editor.
"Foods grown locally are going to taste better and may have more nutrients," she explains, while produce that's shipped cross-country after being harvested can lose vitamin C and folate, not to mention flavor.
And what should you whip up from your local riches? Chef Annie Somerville at Greens Restaurant in San Francisco serves orrechiette with mushrooms, broccoli rabe, Italian parsley, hot pepper, olive oil, and Parmesan cheese, or grilled veggie skewers over quinoa or couscous.
Danger zone: Relying on high-fat cheese to flavor veggie-based dishes is not a waist-friendly move, Largeman-Roth warns.
3. Vietnamese
Fresh herbs, lots of vegetables and seafood, and cooking techniques that use water or broth instead of oils -- these are some of the standout qualities of Vietnamese food.
"This cuisine, prepared the traditional way, relies less on frying and heavy coconut-based sauces for flavor and more on herbs, which makes it lower in calories," Largeman-Roth explains.
Traditional Vietnamese flavorings (including cilantro, mint, Thai basil, star anise, and red chili) have long been used as alternative remedies for all sorts of ailments, and cilantro and anise have actually been shown to aid digestion and fight disease-causing inflammation.
One of the healthiest and most delicious Vietnamese dishes is pho (pronounced "fuh"), an aromatic, broth-based noodle soup full of antioxidant-packed spices.
Danger zone: If you're watching your weight, avoid the fatty short ribs on many Vietnamese menus.
4. Japanese
When Miller was traveling around the world doing research for her book, she found that traditional Japanese cuisine -- especially the version eaten on the island of Okinawa, where people often live to 100-plus -- was superhealthy.
"Not only are Okinawans blessed with a diet rich in cancer-fighting fruits and vegetables, but they also prepare them in the healthiest way possible, with a light steam or a quick stir-fry," Miller explains.
They also practice Hara Hachi Bu, which means "eat until you are eight parts (or 80 percent) full," she says. These simple diet rules may be why people in Japan are far less likely than Americans to get breast or colon cancer.
Japanese staples that are amazing for your health include antioxidant-rich yams and green tea; cruciferous, calcium-rich veggies like bok choy; iodine-rich seaweed (good for your thyroid); omega-3-rich seafood; shiitake mushrooms (a source of iron, potassium, zinc, copper, and folate); and whole-soy foods.
"The soy that's good for you is unprocessed, not made into fake meat," Miller says. Think: tofu, edamame, miso, and tempeh, a nutty tasting soybean cake made from fermented soybeans.
Healthy choices the next time you visit a Japanese restaurant? Miso soup, which typically contains seaweed and tofu, or a simple veggie-and-tofu stir-fry.
Danger zone: White rice can cause a spike in blood sugar, so ask for brown rice, rich in fat-burning resistant starch (RS).
5. Indian
Say "Indian food," and you probably think of its aromatic spices, such as turmeric, ginger, red chilies, and garam masala (a mixture of cumin, cardamom, black pepper, cinnamon, coriander, and other spices).
These distinctive flavors do more than perk up your favorite curry: They may actually protect against some cancers. And turmeric and ginger help fight Alzheimer's, according to recent studies. Researchers point to the fact that rates of Alzheimer's in India are four times lower than in America, perhaps because people there typically eat 100 to 200 milligrams of curry everyday.
Turmeric, a main ingredient in curry, may have anti-inflammatory and healing properties; its benefits are now being studied at the University of California at Los Angeles.
Other good-news ingredients in Indian cuisine include yogurt and lentils, a fiber-and-RS all-star that has significant amounts of folate and magnesium, and may help stabilize blood sugar. Lentils are often combined with Indian spices to make dal, usually served as a side dish.
"A vegetable curry with dal is a great choice at an Indian restaurant," Largeman-Roth says.
Danger zone: Avoid anything fried, like samosas (pastry puffs) as well as heavy curries made with lots of cream and butter.
6. Italian
The Italian tradition of enjoying a leisurely meal is good for digestion. But what really makes this cuisine a winner is its star ingredients: tomatoes, olive oil, garlic, oregano, parsley, and basil.
"Studies have shown that the lycopene in tomatoes may help protect women from breast cancer," Miller says.
One of the best ways to get cancer-fighting lycopene is in cooked tomato products: a half-cup of tomato sauce has more than 20 milligrams. Plus, garlic and traditional Italian herbs provide vitamins A and C. And olive oil helps lower cholesterol, fight heart disease, and burn belly fat.
Notice that melted cheese isn't on that list of power Italian staples: Italians typically use Parmesan or another hard cheese instead, grated in small amounts for a big flavor boost.
Danger zone: Americanized dishes like double-cheese pizza or gooey lasagna tend to be loaded with fat and calories, Largeman-Roth says.
7. Spanish
Our judges applaud the Spanish tradition of eating tapas (small plates of food): "I love the idea of being able to sample little portions of tasty, healthful foods and making a dinner of it," Largeman-Roth says.
The Spanish eat tons of fresh seafood, vegetables, and olive oil -- all rock stars when it comes to your weight and well-being. Superhealthy dishes to order: gazpacho (full of cancer-fighting lycopene and antioxidants) and paella (rich in fresh seafood, rice, and veggies).
Danger zone: Avoid fatty sausages and fried items, which can show up on tapas menus in the United States.
8. Mexican
Forget those high-fat, calorie-stuffed options at many popular Mexican restaurants: Authentic Mexican cuisine can be heart-healthy and even slimming, our judges say. In fact, a Mexican diet of beans, soups, and tomato-based sauces helped lower women's risk of breast cancer, a study from the University of Utah found.
And the cuisine's emphasis on slowly digested foods like beans and fresh ground corn may provide protection from type 2 diabetes.
"Slow-release carbohydrates have been shown to lower blood sugar and even help reverse diabetes," Miller says.
Danger zone: It can be easy to overeat rich queso dip; keep fat and calories in check by portioning a little out of the dip bowl.
9. South American
With 12 countries within its borders, South America has a very diverse culinary repertoire. But our judges applaud the continent's traditional diet of fresh fruits and vegetables (including legumes) along with high-protein grains like quinoa. In fact, a typical South American meal of rice and beans creates a perfect protein, Largeman-Roth says.
While some parts of South America are famous for their huge steaks, a healthier option (unless you share the steak with friends) is ceviche. This mélange of fresh seafood boasts a variety of healthful spices and ingredients, from cilantro and chile peppers to tomatoes and onions.
Danger zone: Brazilian or Argentine restaurants often have fried items like sausage, yams, and bananas. If you're trying to lose pounds, steer clear or split an order with the table.
10. Thai
Can a soup fight cancer? If it's a Thai favorite called Tom Yung Gung, the answer just might be yes.
Made with shrimp, coriander, lemongrass, ginger, and other herbs and spices used in Thai cooking, the soup was found to possess properties 100 times more effective than other antioxidants in inhibiting cancerous-tumor growth.
Researchers at Thailand's Kasetsart University and Japan's Kyoto and Kinki Universities became interested in the soup's immune-boosting qualities after noticing that the incidence of digestive tract and other cancers was lower in Thailand than in other countries.
Many common Thai spices have feel-great benefits, our judges point out. Ginger aids in digestion, turmeric is an anti-inflammatory, and lemongrass has long been used in Asian medicine to help treat colds and ease tummy troubles.
Danger zone: When you're eating out, avoid soups with coconut milk because they're high in saturated fat (and calories).
Source: CNN
| | Study links pesticides to attention problems Wed 25th August 2010 | WASHINGTON (Reuters) - Children whose mothers were exposed to certain types of pesticides while pregnant were more likely to have attention problems as they grew up, U.S. researchers reported on Thursday.
The study, published in Environmental Health Perspectives, adds to evidence that organophosphate pesticides can affect the human brain.
Researchers at the University of California Berkeley tested pregnant women for evidence that organophosphate pesticides had actually been absorbed by their bodies, and then followed their children as they grew.
Women with more chemical traces of the pesticides in their urine while pregnant had children more likely to have symptoms of attention deficit hyperactivity disorder, or ADHD, at age 5, the researchers found.
"While results of this study are not conclusive, our findings suggest that prenatal exposure to organophosphate pesticides may affect young children's attention," Amy Marks and colleagues wrote in the study, available at http://ehp03.niehs.nih.gov/article/info:doi/10.1289/ehp.1002056
To test for ADHD, the researchers questioned the mothers and also gave the children standardized tests.
Organophosphates are designed to attack the nervous systems of bugs by affecting message-carrying chemicals called neurotransmitters including acetylcholine, which is important to human brain development.
The researchers tested Mexican-American women living in the Salinas Valley of California, an area of intensive agriculture.
They looked for breakdown products or metabolites from pesticides in urine samples from the mothers during pregnancy and from their children as they grew.
Few symptoms showed up at age 3, but by age 5 the trend was significant, Marks and colleagues found.
A tenfold increase in pesticide metabolites in the mother's urine correlated to a 500 percent increase in the chances of ADHD symptoms by age 5, with the trend stronger in boys.
A smaller increase in risk was seen if the children had pesticide metabolites in the urine.
In May a different team found children with high levels of organophosphate traces in the urine were almost twice as likely to develop ADHD as those with undetectable levels.
There are about 40 organophosphate pesticides such as malathion registered in the United States. Studies have also linked exposure to Parkinson's, an incurable brain disease.
Source: Reuters
| | Even briefly overeating has lasting effects Wed 25th August 2010 | The effects of a sedentary, gluttonous lifestyle are hard to shake, even after the person has become an upstanding, healthy individual, a new Swedish study suggests.
Researchers found that even a short period of overeating and a lack of exercise can have lasting effects on a person's physiology and make it harder to lose weight and keep it off.
Eighteen healthy people of normal weight were given the arduous task of limiting their physical activity (to no more than 5,000 steps a day) and increasing their food intake for four weeks. The participants in this so-called intervention group ate 70 percent more food, for a total of about 5,753 calories a day, over the study period.
At the study's start, the participants, whose average age was 26, had to be willing to gain between 5 percent and 15 percent of their weight in the name of science.
A second, control group ate and exercised as they normally would.
The couch-potato group added 14 pounds on average, with gains in both their body fat and their fat-free body mass. Six months after the group was allowed to go back to eating normally and exercising, they lost 71 percent of the gained weight, on average.
However, one year after the study period, those individuals still had more body fat than they did at the study's start.
For instance, compared with a baseline of about 20 percent body fat by weight, the gluttonous group had about 24 percent six months after the study period. And after a year, almost half of the body-fat increase was still there. Their fat-free body mass had dropped to baseline values by then.
The difference between the groups was even greater after 2.5 years, when participants in the overeating group showed a gain of 6.8 pounds from the baseline. Meanwhile, the control group didn't show any significant weight gain.
"The long-term difference in body weight in the intervention and control groups suggests that there is an extended effect on fat mass after a short period of large food consumption and minimal exercise ," said study researcher Åsa Ernersson of Linköping University in Sweden.
The research was funded by the University Hospital of Linköping Research Funds, Linköping University, Gamla Tjänarinnor, Medical Research Council of Southeast Sweden, and the Diabetes Research Centre of Linköping University. The results will be published in an upcoming issue of the journal Nutrition & Metabolism.
Source: MSNBC News
| | Berries May Slow Mental Decline From Ageing Wed 25th August 2010 | Study Shows Blueberries, Strawberries, and Acai Berries Are Good for Your Brain's Health
Compounds found in various berries and possibly in walnuts may slow down natural aging processes in the brain, new research indicates.
What's more, blueberries, strawberries, and acai berries may help the aging brain in a crucial but previously unrecognized way, according to a study presented at the National Meeting of the American Chemical Society in Boston.
Scientists say they have found evidence that compounds in the berries and maybe walnuts activate the brain's natural "housekeeper" mechanism that cleans up and recycles toxic proteins, which have been linked to age-related mental decline and memory loss.
"The good news is that natural compounds called polyphenols found in fruits, vegetables and nuts have an antioxidant and anti-inflammatory effect that may protect against age-associated decline," Shibu Poulose, PhD, a scientist with the U.S. Department of Agriculture-Agriculture Research Service's Human Nutrition Research Center on Aging, says in a news release.
Poulose says previous research has suggested that one factor involved in aging is a steady decline in the body's ability to protect itself against inflammation and oxidative damage, which can leave people vulnerable to degenerative brain diseases, cancer, and heart disease.
He says research he's done in the past has shown that old laboratory rats that were fed for two months on diets containing high-antioxidant strawberry, blueberry, or blackberry extract showed a reversal of age-related declines in nerve function and behavior involving learning and memory.
The Benefits of Berries
In the new study involving mouse brain tissue, Poulose says he and his colleague investigated cells called microglia, which collect waste products of the nervous system, and found that in aging they stop working properly.
When that happens, the biochemical waste builds up, and the normally protective cells become overactivated to the point that they damage healthy cells.
"Our research suggests that the polyphenolics in berries have a rescuing effect," he says in the news release. "They seem to restore the normal housekeeping function. These findings are the first to show these effects of berries."
Poulose says the study provides more reason to eat foods rich in polyphenols. These include, in addition to berries and walnuts, many other fruits and vegetables, especially those with deep red, orange, or blue colors.
Frozen berries, he says, also are good sources of polyphenols and are available all year.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
| | Vit D linked to cancer, autoimmune disease genes Tue 24th August 2010 | LONDON (Reuters) - Scientists have found that vitamin D influences more than 200 genes, including ones related to cancer and autoimmune diseases like multiple sclerosis -- a discovery that shows how serious vitamin D deficiency can be.
Worldwide, an estimated one billion people are deficient in vitamin D, and a team of scientists from Britain and Canada said health authorities should consider recommending supplements for those at most risk.
"Our study shows quite dramatically the wide-ranging influence that vitamin D exerts over our health," said Andreas Heger of the Functional Genomics Unit at Britain's Oxford University, who led the study.
Vitamin D effects our DNA through something called the vitamin D receptor (VDR), which binds to specific locations of the human genome. Heger's team mapped out these points and identified more than 200 genes that it directly influences.
Vitamin D deficiency is a well-known risk factor for rickets, and some evidence suggests it may increase susceptibility to autoimmune diseases such as multiple sclerosis (MS), rheumatoid arthritis and type 1 diabetes, as well as certain cancers and even dementia.
With this is mind, the group looked at disease-associated regions of the gene map to see if they had higher levels of VDR binding. They found VDR binding was "significantly enriched" in regions linked to several common autoimmune diseases, such as MS, type 1 diabetes and Crohn's disease, as well as in regions associated with cancers such as leukemia and colorectal cancer.
"SUNSHINE VITAMIN"
Sreeram Ramagopalan, of the Wellcome Trust Center for Human Genetics at Oxford University, said the results, published on Monday in the journal Genome Research, showed "just how important vitamin D is to humans, and the wide variety of biological pathways that vitamin D plays a role in."
Most Vitamin D is made by the body as a natural by-product of the skin's exposure to sunlight. It can also be found in fish liver oil, eggs and fatty fish such as salmon, herring and mackerel, or taken as a supplement.
Some experts say that up to half the world's population has lower than optimal levels of vitamin D, and that about one billion people are actually vitamin D deficient. The problem is getting worse as people spend more time indoors.
A study published in March found that vitamin D is vital for activating the immune system's killer cells, known as T cells, which remain dormant and unaware of threats from infections if vitamin D is lacking in the blood.
Ramagopalan said the latest study suggested vitamin D played a role "in susceptibility to a host of diseases" and that health authorities should consider giving supplements to pregnant women and young children as a preventative measure.
"Vitamin D supplements during pregnancy and the early years could have a beneficial effect on a child's health in later life," he wrote. "Some countries such as France have instituted this as a routine public health measure."
There are no definitive studies on the optimal daily dose of vitamin D but some experts recommend 25 to 50 micrograms.
Source: Reuters
| | Killer Animals, Live-Saving Cures: Why Venom Is Good For You Tue 24th August 2010 | You wouldn't want a deathstalker scorpion in your boot. But it could save your life. Tarantula venom may seem frightful. But medically speaking, it's awesome. And gila monster spit? Great stuff, if you have diabetes.
They're just a few examples of a fascinating area of research using the venom from the most dangerous creatures around. Step on one and it could kill you, but synthesize those toxins in the lab, and they could be used to save your life.
The University of Washington recently announced the latest breakthrough in this field, explaining how scorpion venom can be useful in treating brain cancer. Researchers found that chlorotoxin,an amino acid found in deathstalker scorpions, can slow the cancer's spread by blocking narrow channels in the brain through which malignant, shape-shifting cells can migrate.
But it's only the latest in a long line of scientific studies:
* Apitherapy -- the use of honey bee products -- has been used in treating multiple sclerosis patients. Controlled stinging around the spine brought back sensation and immune response, where numbing and desensitization had previously been crippling.
* Byetta, a drug for diabetics, synthesizes an enzyme found in Gila monster spit. The venomous lizard's output can produce insulin in the pancreas in response to raised blood sugar during slow digestion.
* According to biophysicists at the University of Buffalo, tarantula venom, which contains the protein GSMTx4, may replace morphine for pain relief from muscular dystrophy.
* And snake venom? Don't get started on snake venom. The Natural Toxins Research Center at Texas A&M University has had an active venom research program for 30 years (and a computer-controlled serpentarium!) dedicated to discovering medically important toxins in venom from such snakes as cottonmouths, copperheads and rattlesnakes.
Plus, of course, there's Botulinium toxin A -- the bacterium behind one of the most deadly neurotoxins we know, and the source of the botox injections that make us oh-so-pretty.
Botox essentially paralyzes facial muscles that would otherwise cause the appearance of wrinkles, and is feared as a potential bioweapon -- in far greater doses, of course, than doctors would ever administer.
In 2006, Botox met its match in the topical cream Syn-ake. It contains a synthetic compound that imitates a chemical found in Temple Viper venom, and works in a similar way, inhibiting muscles.
Vipers, toxins and venoms, oh my!
Never fear: The University of Washington's scientists aren't working directly with those deathstalker scorpions.
"We don't extract venom or [chlorotoxin] from scorpions at UW, and never deal with any live scorpions," Miqin Zhang, lead researcher from the University of Washington's department of materials science and engineering, told FoxNews.com. Her lab purchases the chemical from commercial companies or synthesizes it in the labs via recombinant DNA technology, she explained.
Zhang settled on scorpion chlorotoxin when researchers discovered it can enter cells and target certain cancerous brain tumors, called gliomas. This means it's good for gene therapy (the process of replacing absent or faulty genes) -- and less invasive to benign cells.
She said chlorotoxin is so successful because of its interaction with MMP-2, a common enzyme in humans notably associated with the body's response to infections. Highly invasive cancers often increase MMP-2's prevalence, she explained.
"We believe that many types of cancer actually express MMP-2," Zhang told FoxNews.com, causing the body to react and those gliomas to develop. "Chlorotoxin blocks MMP-2 or the expression of MMP-2, and thus blocks the foundation of the glioma," Zhang told FoxNews.com.
While a clinical trial is not yet in the works, her lab's findings have renewed interest in the 15-year-old field of research into scorpion venom. "Ninety-eight percent of brain tumors have the MMP-2 receptor," Zhang said. "The mechanisms are not completely understood yet, but a brain tumor has several hundred types of cancer, and chlorotoxin can target a lot of them."
And the applications could reach beyond brain cancer. "We found that chlorotoxin also targets prostate cancer and melanoma," she said.
The irony of medically useful predators is not limited to the venomous animal kingdom; just look to traditional Chinese medicine. With products ranging from the well-known malaria treatment drug Artemisinin and the now-banned weight loss drug Ephedra, and even the sale of animal parts from endangered species like the Sumatran Tiger, Chinese doctors have mined a variety of animal parts.
According to the World Wildlife Federation, traditional Chinese medicines include the use of tiger bone for arthritis, rhino bones for fever, convulsions, and delirium, and bear gall bladder bile for inflammation and bacterial infections. These 3,000-year-old medical practices abated during the tiger conservation crisis of the '80s and '90s, when the tiger population was estimated at 5,000 to 7,000.
Despite their endangerment, tigers are still killed for their alleged cure-all parts: whiskers, teeth, blood, skin, stomach, eyes, noses, tails, and testes apparently treat everything from tuberculosis and rheumatism to laziness and impotence.
The next time you stumble across a rattlesnake in your scrub brush or a black widow in your bushes, give a care. That killer may someday prove a savior.
Source: Fox News
| | New mouse virus found in chronic fatigue patients Tue 24th August 2010 | WASHINGTON (Reuters) - Researchers have linked a second type of mouse virus to a baffling condition called chronic fatigue syndrome, but said their findings do not yet prove that any virus causes the symptoms.
They found evidence of murine leukemia virus, which causes cancer in mice, in 86 percent of chronic fatigue patients they tested, but in fewer than 7 percent of healthy blood donors.
The team, lead by Harvey Alter of the National Institutes of Health, said much more study is needed to determine how common the virus is in people and whether it might be causing disease, or whether it is an innocent bystander.
But they say their finding adds to evidence that viruses may be linked with the debilitating condition.
It is the second mouse virus to be linked to chronic fatigue syndrome. Another study in 2009 found xenotropic murine leukemia virus-related virus or XMRV in some patients with chronic fatigue syndrome but several others since then have found no such link.
Evidence of XMRV has also been found in prostate tumors, but again, scientists are unsure if the virus may actually be causing the tumors.
Writing in the Proceedings of the National Academy of Sciences, the researchers stressed that the study raises at least as many questions as it answers and said it is too soon to say that viruses cause chronic fatigue syndrome.
"Chronic fatigue syndrome is a debilitating disorder defined solely by clinical symptoms," the researchers wrote. There is no good test for the syndrome, which can leave patients unable to work.
FINDING A CAUSE
Scientists have been looking for a possible infectious disease cause. "However, no single agent has been associated with a large fraction of cases," the researchers wrote.
Years ago, researchers took blood samples from 37 well-studied chronic fatigue patients, looking to see if an organism called Mycoplasma might be the cause.
It was not, and the researchers froze the samples. When a study suggested XMRV might be linked, Dr. Shyh-Ching Lo of the U.S. Food and Drug Administration took a closer look at the frozen samples.
He found DNA sequences that looked something like XMRV, but they turned out to be from different types of mouse leukemia viruses. "This is thought to be a closely related family of viruses," Alter told reporters in a telephone briefing.
They found these genetic sequences in 32 of 37 samples, or 86.5 percent. While 6.8 percent of 44 healthy blood donors had such genes.
More study is needed to show if the viruses actually cause chronic fatigue syndrome and if perhaps blood donations need to be checked, Alter's team said. They will also need to try to find the whole virus in tissue samples -- not just genetic sequences.
It may be possible that chronic fatigue syndrome represents several different diseases, some of which are caused by the viruses, Alter said.
The search will not be easy, as the syndrome is not well defined and patients may often not even known they have it, or may not have been diagnosed.
"Although it is theoretically plausible that XMRV can be transmitted through blood transfusion, no such transmission event has been identified, and there is no known evidence of XMRV infection or XMRV-related illness in transfusion recipients," the FDA said in a statement.
Source: Reuters
| | Kudzu extract may treat cocaine addiction-study Mon 23rd August 2010 | WASHINGTON (Reuters) - An extract of the kudzu vine being developed to treat alcoholism may also help treat cocaine addiction, researchers at Gilead Sciences Inc reported on Sunday.
Tests on rats showed the drug could stop them from giving themselves cocaine, the Gilead team reported in the journal Nature Medicine.
Gilead inherited the experimental drug last year when it acquired CV Therapeutics Inc. A spokesman for the company said it was working to try to bring the drug to market.
"There is no effective treatment for cocaine addiction despite extensive knowledge of the neurobiology of drug addiction," wrote Lina Yao, Ivan Diamond and colleagues.
Kudzu is an old remedy for alcoholism. The vine, native to Asia, has spread across much of the U.S. Southeast after being imported to control soil erosion.
CV Therapeutics made a synthetic extract called selective aldehyde dehydrogenase-2 inhibitor or ALDH2i. It carries the experimental name CVT-10216.
Tests on rats showed it could stop them from giving themselves cocaine. It can also prevent relapse after rats are weaned off cocaine.
They found how it works -- by raising levels of a compound called tetrahydropapaveroline or THP. Cocaine cravings make levels of a brain chemical called dopamine soar and THP interferes with this.
"We propose that a safe, selective, reversible ALDH-2 inhibitor such as ALDH2i may have the potential to attenuate human cocaine addiction and prevent relapse," the researchers wrote.
Source: Reuters
| | Arthritis protein 'guards against Alzheimer's disease' Mon 23rd August 2010 | A protein produced in cases of rheumatoid arthritis appears to protect against the development of Alzheimer's disease, US scientists have said.
In the Journal of Alzheimer's Research study, mice with memory loss given the protein fared better in tests.
A synthetic version of GM-CSF protein is already used as a cancer treatment.
UK experts said the study was "an important first step" and tests were needed to see if the drug worked for people with Alzheimer's.
In people with rheumatoid arthritis, the immune system goes into "overdrive" and produces attacking proteins - including GM-CSF.
Rubbish collectors
It had already been recognised that people with rheumatoid arthritis were less likely to develop Alzheimer's, but the protective link had been thought to be due to non-steroidal anti-inflammatory drugs (NSAIDs) taken by people with the condition.
However tests showed this was not the case.
In this study, University of South Florida researchers genetically altered mice to have memory problems similar to those seen in Alzheimer's disease, which is a form of dementia.
They then treated them - and some healthy mice - with the protein. Other mice - both healthy ones and those with Alzheimer's symptoms - were given a dummy (placebo) treatment.
At the end of the 20-day study, the Alzheimer's mice treated with GM-CSF fared substantially better on tests measuring memory and learning, and performed at a similar level to mice of the same age without the condition.
Even the healthy mice treated with GM-CSF performed slightly better than their untreated peers.
Mice with Alzheimer's that were given the placebo continued to do poorly in the tests.
The researchers have suggested the protein may attract an influx of cells called microglia from the peripheral blood supply around the brain, which then attack the characteristic plaques that form in people with Alzheimer's.
Microglia are like the body's natural "rubbish collectors" that go to damaged or inflamed areas to get rid of toxic substances.
The brains of GM-CSF-treated Alzheimer's mice showed more than a 50% decrease in beta amyloid, the substance which forms Alzheimer's plaques.
The researchers also observed an apparent increase in nerve cell connections in the brains of the GM-CSF-treated mice, which they say could be a reason memory decline was reversed.
'Crucial next stage'
Dr Huntington Potter, who led the research at the University of South Florida's Health Byrd Alzheimer's Institute, said: "Our findings provide a compelling explanation for why rheumatoid arthritis is a negative risk factor for Alzheimer's disease."
An artificial version of GM-CSF, a drug called Leukine, is already approved by the US Food and Drug Administration and has been used to treat cancer patients who need to generate more immune cells.
Dr Potter added. "Our study, along with the drug's track record for safety, suggests Leukine should be tested in humans as a potential treatment for Alzheimer's disease."
Dr Simon Ridley, head of research at the UK's Alzheimer's Research Trust, said: "Positive results in mice can be an important first step for any new treatment, and it's encouraging the team is already planning the crucial next stage of a trial in people.
"We won't know whether GM-CSF can help people with Alzheimer's until clinical trials are completed".
Dr Susanne Sorensen, head of research at the Alzheimer's Society, said: "This exciting research provides a possible answer to the long, unexplained question of why rheumatoid arthritis could reduce the risk of Alzheimer's disease.
"Given the identified protein is already available as a drug that is proven to be safe in humans, the time taken to develop an Alzheimer's disease treatment could be substantially reduced.
"However, we must not jump the gun. Much more research is needed before we can say for certain that the findings demonstrated in mice would also occur in humans."
Source: BBC
| | Bottled vs. brewed teas: Study reveals healthiest teas Mon 23rd August 2010 | Labels on bottled tea beverages are typically plastered with declarations of their rich antioxidant content. But a new study suggests, if you're looking for high doses of healthful antioxidants, you might be better off brewing your tea at home.
Many of the popular beverages included in the study contain fewer antioxidants than a single cup of home-brewed green or black tea, the researchers say. Some store-bought teas contain such small amounts that consumers would have to drink 20 bottles to get the antioxidants, also called polyphenols, present in one cup of tea.
"There is a huge gap between the perception that tea consumption is healthy and the actual amount of the healthful nutrients — polyphenols — found in bottled tea beverages. Our analysis of tea beverages found that the polyphenol content is extremely low," said study researcher Shiming Li, an analytical and natural product chemist at WellGen, Inc., a biotechnology company in North Brunswick, N.J., that develops medical foods for patients with diseases, including a proprietary black tea product that will be marketed for its anti-inflammatory benefits.
In addition, bottled beverages often contain large amounts of sugar that health-conscious consumers may be trying to avoid, Li said.
The study was presented Aug. 22 at the 240th National Meeting of the American Chemical Society (ACS) in Boston.
Bottled vs. brewed
Antioxidants are substances that protect cells against damage from unstable molecules called free radicals. They may play a role in preventing a host of diseases, including cancer, cardiovascular disease and Alzheimer's.
Li and colleagues measured the level of polyphenols of six brands of tea purchased from supermarkets. Half of them contained what Li characterized as "virtually no" antioxidants. The rest had small amounts of polyphenols that Li said probably would carry little health benefit, especially when considering the high sugar intake from tea beverages.
The six teas Li analyzed contained 81, 43, 40, 13, 4, and 3 milligrams of polyphenols per 16-ounce bottle. One average cup of home-brewed green or black tea, which costs only a few cents, contains 50-150 milligrams of polyphenols.
Less tea, more water
|After water, tea is the world's most widely consumed beverage. Tea sales in the United States have quadrupled since 1990 and now total about $7 billion annually.
Some manufacturers do list polyphenol content on the bottle label, Li said. But the amounts may be incorrect, because there are no industry or government standards or guidelines for measuring and listing the polyphenolic compounds in a given product. A regular tea bag, for example, weighs about 2.2 grams and could contain as much as 175 mg of polyphenols, Li said. But polyphenols degrade and disappear as the tea bag is steeped in hot water. The polyphenol content also may vary as manufacturers change their processes, including the quantity and quality of tea used to prepare a batch and the tea brewing time.
"Polyphenols are bitter and astringent, but to target as many consumers as they can, manufacturers want to keep the bitterness and astringency at a minimum," Li explained. "The simplest way is to add less tea, which makes the tea polyphenol content low but tastes smoother and sweeter."
Li used a standard laboratory technique, termed high-performance liquid chromatography (HPLC), to make what he described as the first measurements of polyphenols in bottled tea beverages. He hopes the research will encourage similar use of HPLC by manufacturers and others to provide consumers with better nutritional information.
Source: MSNBC
| | Common acne treatments linked to bowel problems Sat 21st August 2010 | NEW YORK (Reuters Health) - Acne is a difficult enough burden for a young person to bear. Now there's evidence that antibiotics commonly prescribed to help control severe breakouts may, in a very small number of patients, lead to inflammatory bowel disease.
Bowel disorders linked to acne treatment are "a rare outcome," cautioned Dr. David Margolis, a dermatologist and lead author of a study in the American Journal of Gastroenterology, in an interview with Reuters Health.
Nonetheless, previous studies have suggested that the acne drug isotretinoin, known commonly by the brand name Accutane, might be the cause of inflammatory bowel disease in a small number of patients being treated for severe acne.
Noting that most people given isotretinoin have already been taking antibiotics for months, if not years, Margolis and colleagues at the University of Pennsylvania wanted to know if antibiotics might play a role in triggering the bowel condition.
Up to 90 percent of teenagers and young adults battle acne at some point. Drugs from the tetracycline family are the most commonly prescribed antibiotics for the treatment of severe acne.
"They limit scarring and the outbreak of pimples. They're exceedingly effective and have been used for years," Margolis said.
The researchers looked at the medical records of more than 94,000 British teenagers and young adults diagnosed with acne between 1998 and 2006.
They found that long-term use of antibiotics appeared to double the risk of developing inflammatory bowel disease in these subjects. Of the 207 cases of inflammatory bowel disease diagnosed among the 94,487 patients in the study, 152 (0.26 percent of all subjects) were taking one of three commonly prescribed tetracycline-based antibiotics and 55 (0.14 percent) were not.
Patients taking one of the three drugs, doxycycline, appeared to be at a slightly higher risk (0.21 percent) of developing an inflammatory bowel disease compared to patients taking minocycline (0.17 percent risk) or tetracycline (0.20 percent risk).
"The association was probably most pronounced in terms of Crohn's disease, a subgroup," Margolis said.
Crohn's disease is an inflammation of the lining of the digestive tract, which can lead to abdominal pain, severe diarrhea and malnutrition. It affects an estimated 400,000 people in the U.S. Some 600,000 Americans suffer another inflammatory bowel disease, ulcerative colitis. Both are treated with anti-inflammatory drugs and some complications of the conditions can require surgery.
"This potential risk should be considered when prescribing this medication," the authors write, while also urging more study of the connection between acne drugs and bowel disorders. It is possible, for instance, that the risk of inflammatory bowel disease is related to the biology of severe acne itself and not to treatments for it, they note.
"This is a rare outcome, rare enough you need to be careful about making decisions to change clinical practice," Margolis said.
Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, can be life-altering conditions that restrict social interactions and increase depression.
Severe acne is also a "bad disease," Margolis said. "These people have lots of concerns about their health, their appearance and how they function in society, and they are at an increased risk of depression," Margolis pointed out.
Margolis was prompted to conduct the study after being asked to review records by lawyers representing a generic manufacturer of isotretinoin. The legal case is still in the discovery phase.
"I'm not sure if isotretinoin (Accutane) is on or off the hook all by itself," he said. "I think this research indicates that in a careful study one should probably consider antibiotic use," as well, he added.
SOURCE: http://link.reuters.com/dur36n American Journal of Gastroenterology, available online August 10, 2010.
| | Hormone replacement may not save women's muscle Sat 21st August 2010 | NEW YORK (Reuters Health) - Despite some earlier evidence that hormone replacement therapy after menopause can help maintain women's muscle mass, a new study suggests that any such benefit does not last.
That women's muscle mass declines after menopause has long been known, and researchers have speculated that waning estrogen levels may play a role -- raising the question of whether hormone replacement therapy (HRT) can help preserve older women's muscle mass.
Results from the Women's Health Initiative (WHI), a large U.S. clinical trial looking at a variety of health effects of HRT, found that women who used hormones for three years maintained somewhat more muscle mass than those who had been given a placebo for comparison.
In this latest analysis of the WHI data, however, researchers found no muscle-mass advantage from HRT after six years.
The findings, published in the journal Menopause, are in line with another recent analysis from the WHI that found no evidence HRT preserved women's muscle strength or walking speed over six years.
The new results also add to a larger picture of disappointing findings on the expected benefits of HRT -- most famously, its failure to lower women's risk of developing heart disease after menopause.
The WHI was a large government-sponsored clinical trial begun in 1993, in which postmenopausal women were randomly assigned to take either HRT or placebo pills.
The trial was halted in 2002, when researchers found that women on HRT were not only not protected from heart disease, but showed higher rates of heart attack, stroke, breast cancer and blood clots than placebo users.
As a result, experts now advise that while HRT is effective at relieving menopausal symptoms -- like hot flashes and vaginal dryness -- women should take it at the lowest dose and for the shortest time possible.
Researchers are, however, still analyzing data from the WHI to tease out the health effects, both positive and negative, that can be linked to hormone replacement.
For the current study, investigators led by Dr. Jennifer W. Bea, of the Arizona Cancer Center in Tucson, analyzed data from a subgroup of 1,941 women who took part in the WHI trial. About half were randomly assigned to take placebos, while the rest were given either estrogen alone or estrogen plus progestin.
At the trial's outset, then again three and six years later, the proportion of muscle and fat in each woman's body was measured by DXA scans, a type of X-ray used in everyday medical practice to gauge bone density.
In contrast to the muscle preservation seen after three years in past studies, Bea's team found no evidence that HRT use contributed to greater muscle mass at year six.
Preserving muscle mass and strength with age is considered important because it may help elderly adults maintain their ability to perform routine tasks -- like climbing stairs and carrying groceries -- and possibly reduce their risk of falls and bone breaks.
Bea's team did find that women on HRT had a somewhat lower number of falls than those in the placebo group. But that association was based on a small number of falls, making it hard to tell whether it was a true effect of hormone replacement, the authors pointed out.
The researchers also found no evidence connecting the rate of falls in the different study groups to differences in muscle mass.
Future studies, according to Bea and her colleagues, should continue to look at the relationship between HRT and the risk of falls and bone fractures.
The researchers acknowledge that their study had limitations -- including the use of DXA, which might not be sensitive enough to detect subtle changes in muscle mass.
For now, they conclude, their findings suggest that while HRT might help delay muscle loss, that benefit does not persist long term.
One of the co-researchers on the study is involved in a clinical trial of lasofoxifene, a drug being developed by Pfizer, Inc. to treat osteoporosis, and has received funding from other makers of osteoporosis medications.
SOURCE: http://link.reuters.com/kuv36n Menopause, online August 3, 2010.
| | 'Magic Drug' for Depression Sat 21st August 2010 | A drug known for its recreational use in clubs, may have more immediate, longer-lasting effects for treating depression than the most commonly prescribed antidepressants, London's Daily Telegraph reported.
A study by Yale Researchers found that ketamine, traditionally used as an anesthetic for animals - and in some cases humans - has a "magic" effect on those suffering from depression.
"It's like a magic drug - one dose can work rapidly and last for seven to 10 days," said Dr. Ronald Duman, professor of psychiatry and pharmacology at Yale University, who led the study.
Most antidepressant drugs, like Prozac and Zoloft, can take months or years to take effect and must be taken every day. In the Yale study, a single dose of ketamine stopped the symptoms of depressive behavior in rats within hours and even restored synaptic connections between nerve cells in the brain.
Ketamine has also been shown to effectively treat depressed patients who hadn't responded to years of other treatments. But its clinical use has been limited because it must be injected to work as an antidepressant and causes short-term psychotic symptoms, like hallucinations.
George Aghajanian, professor of pharmacology at Yale University and co-researcher on this study, warned that ketamine required further analysis before it could be approved for general use as an antidepressant.
The study is published in Friday's edition of the journal Science.
Source: Fox News
| | Painkiller use linked to stroke risk Fri 20th August 2010 | NEW YORK (Reuters Health) - Common painkillers that have been linked to an increased risk of heart attack may also elevate risk of stroke, a new study suggests.
Researchers found that among nearly 38,000 Taiwanese adults who suffered a stroke over one year, the use of a non-steroidal anti-inflammatory drug (NSAID) in the prior month may have elevated their stroke risk.
The increases linked to individual NSAIDs were generally modest, the investigators report in the medical journal Stroke. And the findings do not prove that the medications themselves led to some people's strokes.
NSAIDs are a group of painkillers that include over-the-counter medications like aspirin, ibuprofen (Advil, Motrin and other brands) and naproxen (Aleve), as well as prescription arthritis drugs known as COX-2 inhibitors.
The COX-2 inhibitors were first linked to an increased risk of heart attack and other cardiovascular problems, and two of the drugs -- rofecoxib (Vioxx) and valdecoxib (Bextra) -- were pulled from the market in 2004 and 2005, respectively; a third COX-2 inhibitor, celecoxib (Celebrex) remains on the market.
But subsequent studies also raised concerns about the possible heart risks of some of the older, over-the-counter NSAIDs, including ibuprofen and diclofenac (Voltaren).
These latest findings suggest that the "concern may also extend to the risk of stroke," said Dr. Elliott Antman, a professor of medicine at Harvard Medical School and Brigham and Women's Hospital in Boston who was not involved in the study.
The new results do underscore the general recommendation that, to limit any cardiovascular risks, people should use NSAIDs at the lowest dose and for the shortest time necessary to relieve their pain, added Antman, who is also a spokesman for the American Heart Association (AHA).
For the current study, researchers led by Dr. Chia-Hsuin Chang of National Taiwan University Hospital used information from Taiwan's national health insurance database. They identified nearly 38,000 adults age 20 or older who had suffered a stroke in 2006, then looked at the patients' NSAID use in the month before the stroke and compared it to use in the prior three to six months.
The specific medications included celecoxib, ibuprofen, naproxen, diclofenac and other oral NSAIDs, as well as ones sometimes given by IV or injection, such as ketorolac (Toradol).
In general, the study found that use of any NSAID in the 30 days before the stroke was linked to an increased risk -- of anywhere from 20 percent to 90 percent for most of the oral NSAIDs, depending on the drug. Oral ketorolac was linked to the greatest risk increase of 2.6-fold.
Antman urged caution in interpreting the last result because it was based on a small number of patients: only 131 had used oral ketorolac in the month before their strokes.
The pattern was seen in patients with cardiovascular risk factors and those without, the researchers say.
While the risk increases may sound big, Chang's team describes them as "small."
It's important to keep in mind, Antman said, that the figures represent relative increases in risk; the absolute risk to any one NSAID user may well be quite small.
For example, the National Institute of Neurological Disorders and Stroke estimates that adults in their 50s who are free of the major stroke risk factors -- including high blood pressure, established heart disease, diabetes and smoking -- have about a 1 percent to 3 percent chance of suffering a stroke in the next 10 years.
So, even a doubling of such a person's short-term stroke risk would still yield a very low absolute risk.
Limiting use of NSAIDS is nevertheless a good idea, said Antman, and especially important for people with established heart disease or its risk factors, such as high blood pressure.
In guidelines published in 2007, the AHA recommended that people first try to ease their aches and pains with acetaminophen (Tylenol), which is not an NSAID, or aspirin -- which, although it is an NSAID, is known to be protective against heart attacks.
Among non-aspirin over-the-counter NSAID products, Antman said, naproxen has so far been shown to be the safest as far as heart risks.
The bottom line, according to Antman, is that even common over-the-counter medications are "real drugs that do have risks." He noted that people should not continue to take NSAIDs beyond the period of time recommended on the label without talking with their doctor first.
It's thought that NSAIDs other than aspirin may contribute to heart problems or stroke for a few reasons, including effects that may make blood clots more likely to form or may create spikes in blood pressure.
SOURCE: http://link.reuters.com/muw95n Stroke, online July 29, 2010.
| | Hormone therapy doesn't boost brainpower: study Fri 20th August 2010 | NEW YORK (Reuters Health) - Hormone therapy with either estrogen or testosterone might not affect women's thinking and memory skills in the years soon after menopause, hints a new study.
The findings are the latest addition to a complicated picture of the possible link between hormones and mental functioning in women. Some researchers think hormone therapy may help improve brain function and prevent Alzheimer's disease after menopause. But then there are studies that show little impact on thinking and memory, or different impacts depending on the age of women being treated.
One recent study of women in surgical menopause - when the uterus and ovaries are removed - suggested that estrogen might provide a memory benefit, but that testosterone canceled out some of that benefit when women took both hormones (see Reuters Health story of July 2, 2010: Testosterone may not help memory after menopause).
"Since many women during the time of menopausal transition complain about cognitive impairment it has been suggested that estrogen may have a beneficial effect on memory and cognitive abilities," while "testosterone is suggested to improve spatial ability but impair verbal memory," Dr. Angelica Linden Hirschberg, one of the current study's authors from the Karolinska Institutet in Stockholm, Sweden, told Reuters Health by email.
Estrogen declines in women as they enter menopause and in the years shortly after, but testosterone levels don't change very much around menopause. Still, both hormones have been used to treat symptoms in postmenopausal women - estrogen to prevent hot flashes and osteoporosis, and testosterone for women who lose their sex drive around this time.
Hormone therapy took a hit in 2002, however, when the Women's Health Initiative study was halted because women taking hormones had higher rates of heart disease, stroke, and breast cancer than women not on hormones.
The pluses and minuses of hormone therapy remain controversial, especially when it comes to its effect on the mind. To try and shed more light on this area, Hirschberg and her colleagues divided 200 women between 50 and 65 years old into three groups. One group took estrogen pills, another took testosterone pills, and a third took placebo pills that didn't contain any hormones. None of the women knew which kind of pill they were taking.
After four weeks of daily treatment, the women were given three thinking and memory tests: in one, they had to list all the words they could think of that started with one letter; in another, they were told to repeat a list of 12 random words; and in the third, they looked at objects on a page and had to choose what that object would look like when it was rotated.
Women in each of the three treatment groups fared similarly on all tests, leading Hirschberg to conclude that short-term treatment with estrogen or testosterone does not affect the mental functions she and her colleagues were evaluating.
The researchers didn't test the women before they started the treatment. But they assumed that because the participants were similar across most other measures, there should be no difference in their thinking and memory skills before some started hormone therapy, they write in the study, which is published in Fertility and Sterility.
Dr. Victor Henderson, an epidemiologist and neurologist at Stanford University, said the study's finding of no relationship between hormone therapy and cognitive skills, at least in the short term, "tend(s) to be consistent with the other studies that are coming out."
However, he said, data are lacking on the longer term effects of estrogen and testosterone in postmenopausal women. "A four-week study may or may not generalize to studies for a longer duration of treatment," Henderson, who was not involved with the current study, told Reuters Health.
"The major unanswered question is whether prolonged hormone exposure...has effects that might show up a decade, two decades, three decades later in terms of things like Alzheimer's risk," he said.
Estrogen pills like the ones used in the study can be purchased over-the-counter for less than 50 cents a day. Testosterone pills cost $2-3 per day, but aren't approved by the Food and Drug Administration for treatment in women. The current study did not mention any side effects from either type of hormone therapy.
While it's still not clear whether hormone therapy can help women improve their brainpower after menopause, Hirschberg said that there are steps women can take to help them stay sharp, including eating a healthy diet and getting regular exercise.
SOURCE: http://link.reuters.com/tus95n Fertility and Sterility, online July 29, 2010.
| | N. Korea Wants to Pay Debt With Ginseng Fri 20th August 2010 | Czech Republic says it wanted zinc, not ginseng, when it suggested $10M barter.
North Korea, the world's most recently declared nuclear weapons power, now wants to pay off some of its outstanding debts -- with ginseng root.
The Czech Republic is pleased to discover that cash-poor North Korea hasn't forgotten $10 million in arrears -- dating to heady cold war comrade days, when then-Czechoslovakia sent machinery, trams, and equipment to Kim Jong-il's father, Kim Il-sung.
Last month, a delegation from Pyongyang arrived in Prague asking forgiveness of some 95 percent of the old debt. Czech authorities pronounced the request "unacceptable" and said "the debt cannot be forgiven," according to a Ministry of Finance statement to the Monitor.
Prague, did suggest, however, that the Democratic People's Republic of Korea could pay back on a barter arrangement that dates to the Soviet era.
The DPRK then offered some $500,000, or 400 tons' worth, of the piquant root used in tea, medicines, soups, and hand cream. North Korean ginseng is considered one of the finest in quality, called "heaven grade" in Asia.
The problem for Czech authorities is that their entire country only consumes 1.4 tons of ginseng a year; the quantity proposed by Pyongyang would last 200 years.
We'd Rather Have Zinc Ore, Please
Czech Finance Ministry officials instead suggested Pyongyang pay in zinc ore, which the Central European nation can process or resell, according to Tomas Zidek, Czech deputy finance minister, in the MF DNES Prague daily.
No word back on the zinc counterproposal from the secretive nation sometimes termed the "hermit kingdom." Czech ministry spokesman Radek Lezatka said that "negotiations will continue" with the DPRK.
Despite Nukes, North Korean Economy Troubled
North Korea's woefully ailing economy is treated as a national secret, as is most information inside the tightly controlled Kim regime. North Korea's international debt figure is widely reported as $12 billion, though this figure dates from a 2001 CIA estimate still notated in the agency's current World Factbook.
North Korea's economy and energy sector, which benefited from both Chinese and Soviet assistance until the early 1990s, has been reduced to less than a shadow of its former self, often rusting and operating off spare parts.
Harvests are uneven and the population outside the special restricted zone of Pyongyang is subject to food shortages and famine. Much of North Korean assistance comes from China; the bridge across the Yalu River from Dandong was loaded with Chinese trucks headed to Pyongyang for much of the past decade.
This summer brought rains and floods, reportedly higher rice prices, and a curtailing of private trading -- all in the midst of ongoing confrontations with South Korea and the U.S. over antisubmarine naval exercises that came after the sinking of a South Korean Navy ship that a U.N. study attributed to the North.
| | More evidence for fibromyalgia, suicide link Thu 19th August 2010 | NEW YORK (Reuters Health) - A study of more than 8,000 Americans with fibromyalgia suggests that they are not at an overall increased risk of dying over a given time compared to people without the chronic pain condition.
Rates of suicide and accidental deaths, however, were higher than average among people with fibromyalgia in the study. Still, the overall risk of suicide was still low and the findings don't prove that fibromyalgia symptoms cause suicide, the authors emphasize.
The results, published in the journal Arthritis Care & Research, come one month after a study of Danish patients with fibromyalgia also found an increased risk of suicide in these patients compared to the general public, but no increased risk of death overall. (See Reuters Health story of July 16, 2010: Fibromyalgia comes with suicide risk: study)
"This is an illness which seems to have major suffering associated with it, but isn't associated with physical changes that lead to increased risk of death," Dr. Frederick Wolfe, the study's lead author from the National Data Bank for Rheumatic Diseases in Wichita, Kansas, told Reuters Health.
Fibromyalgia affects about 2 percent of the U.S. population and is much more common in women than men. People with fibromyalgia suffer from all-over pain and many feel tired all the time. They also have higher-than-average rates of psychiatric illness such as depression or anxiety.
But there has not been definitive data on whether those with the condition have higher rates of death than the general population.
To get at that question, Wolfe and his colleagues tracked patients who had been diagnosed with fibromyalgia between 1974 and 2009. Some of those patients were seen in a local clinic, while others had been referred to the National Data Bank.
The authors collected information on patients' symptoms, including survey responses about their physical and mental health, and kept track of how many patients died from what causes over the course of the study. They were able to follow each patient for an average of 7 years.
Over the course of the study, 539 of the approximately 8,000 fibromyalgia patients died. This is about what would be expected in a similar group of people in the United States without fibromyalgia over a 7-year period.
Accidental deaths were responsible for 7.1 percent of deaths in people with fibromyalgia and 4.4 percent of deaths in these patients were from suicide. In a group of similar age and gender distribution but without fibromyalgia, 5 percent would be expected to die from accidents and 1.4 percent from suicide.
Dr. David Marks, a psychiatrist at Duke University's Durham Regional Hospital in North Carolina who treats patients with fibromyalgia, said he was not surprised by the increased rate of suicide. Like the authors, though, he warned that the overall risk of suicide was still small.
"Unfortunately, (fibromyalgia) is not taken very seriously in the medical community and the community at large," he told Reuters Health. "Sometimes patients don't get a lot of support."
"These patients are very demoralized, they feel very isolated and alone," added Marks, who was not involved with the current research.
Marks speculated that the increased rate in accidental deaths could be due to what's known as "fibro fog," when some people with fibromyalgia "kind of space out," he said.
Marks hopes that the lack of a significant link between fibromyalgia and overall death rates in this study doesn't mean doctors will see the condition as less legitimate. Even if these patients aren't dying any faster than people without fibromyalgia, he said, they're still suffering. And doctors could do more to prevent and ease that suffering.
"I think that overall we could probably do a better job meeting the psychiatric needs of fibromyalgia patients," Marks said. "Fibromyalgia in itself is not just a mood disorder or an anxiety disorder. It is a real phenomenon that needs to be taken more seriously."
SOURCE: http://link.reuters.com/myr34n Arthritis Care & Research, online July 26.
| | Ancient brew may reduce gut damage after chemotherapy Thu 19th August 2010 | HONG KONG (Reuters) - An ancient Chinese brew may help reduce the intestinal damage caused by chemotherapy given to colon and rectal cancer patients, researchers said on Thursday.
To meet growing consumer demands, researchers in the field of traditional medicine are trying to prove the efficacy of ancient drugs using Western-style animal tests and human clinical trials.
In a paper published in Science Translational Medicine, the researchers said they fed cancerous mice the Chinese brew after the rodents had been treated with irinotecan, a chemotherapy drug known to be toxic for the gut and a cause of diarrhea.
"The researchers treated cancerous mice with chemotherapy, which shrank tumors but also caused massive destruction in the intestinal lining of the animals," they said in a statement.
"After a few days of treatment with PHY906, the medicine restored the damaged intestinal linings in the mice."
PHY906 is the laboratory formulation of a 1,800-year-old Chinese formula containing peonies, a purple flower called skullcap, licorice and fruit from a buckthorn tree.
Called Huang Qin Tang, the brew has been used for a long time to treat diarrhea, nausea and vomiting.
"Irinotecan reduces tumor growth by itself but if you combine with PHY906, it will further reduce tumor growth," said lead author Yung-Chi Cheng at the Yale University School of Medicine in the United States.
"By itself, PHY906 does not decrease tumor growth, it has to be used in combination with chemotherapy."
Colorectal cancer is the third deadliest cancer, after lung and stomach cancer. It caused 639,000 deaths globally in 2004, according to the World Health Organization.
According to the American Cancer Society, the economic impact from colorectal cancer in terms of premature death and disability is US$99 billion annually, excluding direct treatment costs.
Cheng said the team has since completed a small clinical trial using the brew on 17 human patients with colorectal cancer.
"The results of the clinical phase 1/2A trial looks promising," Cheng said by telephone, adding that they would be proceeding to a larger clinical trial.
Cheng has a stake in PhytoCeutica, Inc., which develops traditional Chinese medicine into drugs for the treatment of cancer and it holds the license for PHY906.
Source: Reuters
| | Ginseng supplements raise quality concerns Thu 19th August 2010 | Ginseng products didn't make Consumer Reports’ list of "The 12 Most Dangerous Supplements,” but the popular herb still suffers from quality issues, according to a new report (subscription required) from ConsumerLab.com.
In testing, Consumerlab found that five of the 11 supplements it randomly selected-- 45 percent--contained less ginseng than expected from their labels or were contaminated with lead and or pesticides.
The results showed most of the products provided approximately 10 to 40 milligrams (mg) of ginsenosides per day, but some yielded much higher amounts, including one that delivered a whopping 304 mg. "The effects might certainly differ from one product to another," said ConsumerLab president Tod Coperman.
The root of the ginseng plant has been used in Chinese medicine for 2,000 years. Though it’s often promoted for increasing vitality, the strongest evidence shows it may help prevent colds and flu and keep blood sugar levels down in people with diabetes.
The brands tested by Consumerlab.com, which has found quality problems for a decade, included Action Labs, Bluebonnet, Good Neighbor Pharmacy, Imperial (GINCO), Nature Made, Nature’s Bounty, Nature’s Plus, NSI (Vitacost), Pharmanex, Puritan’s Pride, Solgar, Spring Valley (Walmart), TruNature, Vitamin Shoppe, Vitamin World, and Whole Foods.
Source: Chicago Tribune
| | Healthy eating helps reverse metabolic syndrome Wed 18th August 2010 | NEW YORK (Reuters Health) - People with metabolic syndrome -- a cluster of risk factors for heart disease, stroke and type 2 diabetes -- have a better chance of reversing it if they stick to a healthy diet, a new study shows.
While it seems obvious that eating healthy would make you healthier, the findings are important because they show it's a person's dietary pattern, not just individual components of their diet, that matters, Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston, who was not involved in the new study, told Reuters Health.
A person is considered to have metabolic syndrome if they have three or more of the following risk factors: excess belly fat; high triglyceride levels (a harmful blood fat); low levels of "good" HDL cholesterol; high blood pressure; and either high blood sugar levels or type 2 diabetes.
According to the National Heart Lung and Blood Institute (NHLBI), having metabolic syndrome doubles a person's risk of heart disease and quintuples their risk of developing type 2 diabetes. Nearly a quarter of US adults have the metabolic syndrome.
In the current study, Dr. Tasnime N. Akbaraly of University College London and her colleagues looked at whether sticking closely to the Alternative Healthy Eating Index (AHEI) could help reverse metabolic syndrome.
The AHEI is a set of nutritional guidelines published by Harvard School of Public Health researchers in 2002. The guidelines emphasize eating whole grains rather than refined grains, white meat rather than red meat, and lots of fruits, vegetables, nuts and soy. Studies have shown that following the guidelines helps cut the risk of chronic disease in both men and women.
Akbaraly and her colleagues studied 339 people with metabolic syndrome participating in the Whitehall II study, a long-running study investigating social determinants of health in British civil servants. Just over a quarter of the participants were women, and participants' average age was 56.
After five years, nearly half no longer had the metabolic syndrome. People who adhered the most closely to the AHEI, the researchers found, were nearly twice as likely to have reversed their metabolic syndrome.
For people with central obesity, defined as waist circumference above 102 centimeters (40 inches) for men and 88 centimeters (35 inches) for women, those with the healthiest diets were nearly three times as likely to have recovered from metabolic syndrome than those with the unhealthiest eating patterns; healthy eating also had a somewhat stronger effect for people who started out with high levels of harmful triglycerides.
"It's not about focusing on individual components of the diet," Lichtenstein said. "It's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
"It doesn't mean if you sprinkle wheat germ on your hot fudge sundae you're going to get the benefits of whole grains," she added.
In addition to eating well, Lichtenstein said, people shouldn't forget that regular physical activity is also a key component of maintaining heart health.
SOURCE: http://link.reuters.com/quq55n Diabetes Care, online July 29, 2010.
| | Bad bumps to head could kill years later: U.S. study Wed 18th August 2010 | WASHINGTON (Reuters) - Scientists reported on Tuesday they have some of the best evidence yet to support long-held theories that repeated blows to the head may cause nerve-degenerative diseases like Lou Gehrig's disease and Alzheimer's.
Autopsies of 12 athletes who died with brain or neurological disease showed a distinctive pattern of nerve damage -- and fingered some potential culprits.
All had repeated concussions during their careers. Three of the men had been diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease, the star baseball player who died of it.
Experts in brain injury said the study, published in the Journal of Neuropathology & Experimental Neurology, pointed to new areas of research and possible ways to prevent long-term damage from concussions.
"If you could somehow give a person a drug, you could potentially prevent an illness like amyotrophic lateral sclerosis," Dr. Jeffrey Bazarian of the University of Rochester Medical Center in New York said in a telephone interview.
The findings also point to an urgent need to watch veterans of the wars in Iraq and Afghanistan, many of whom suffer brain injuries from explosions, accidents and blows to the head from other causes, the experts said.
"This is the first pathological evidence that repetitive head trauma experienced in collision sports might be associated with the development of a motor neuron disease," Dr. Ann McKee of Boston University School of Medicine and colleagues wrote in the report, available at http://link.reuters.com/fab65n.
McKee's team studied the donated brain and spinal cords of 11 professional football players or boxers and one hockey player. All had a newly characterized disease called chronic traumatic encephalopathy, or CTE, in which dementia set in years after repeated concussions.
PROTEIN CULPRIT
Three of the men also were diagnosed with ALS, a member of a family of diseases called motor neuron disease, which cause progressively worse paralysis.
The researchers looked specifically for a protein called TDP-43. They found it in the brain and in the spinal cords of the men -- which could explain the ALS-like symptoms.
Scientists know that damaging one nerve can sometimes set off a cascade of other nerves dying, for reasons that remain poorly understood. TDP-43 could be involved.
Bazarian, who was on an Institute of Medicine Committee that released a report in 2008 linking concussions to later-life neurologic diseases, said the finding could help explain studies that show Iraq war veterans have a higher-than-normal rate of ALS, for example.
Drugs including the hormone progesterone, monoclonal antibodies and the antibiotic minocycline are being studied to see if they can stop the process of nerve destruction that follows injuries such as a blow to the head or stroke.
The findings will be difficult to substantiate because ALS is so rare, said ALS expert Martina Wiedau-Pazos of the University of California Los Angeles.
"We think there already are different forms of ALS," she said -- potentially with different causes.
David Hovda, director of the UCLA Traumatic Brain Injury Research Center, said brain injury is very common with 1.5 million cases in the United States alone each year.
"Whether by itself in isolation it causes ALS, I do not think that this paper proves that. What I think it does is raise worries that individuals who had a career of exposure to repeat concussions ... have a greater likelihood of developing motor neuron disease," he said.
Source: Reuters
| | Scientists suggest fresh look at psychedelic drugs Wed 18th August 2010 | LONDON (Reuters) - Mind-altering drugs like LSD, ketamine or magic mushrooms could be combined with psychotherapy to treat people suffering from depression, compulsive disorders or chronic pain, Swiss scientists suggested on Wednesday.
Research into the effects of psychedelics, used in the past in psychiatry, has been restricted in recent decades because of the negative connotations of drugs, but the scientists said more studies into their clinical potential were now justified.
The researchers said recent brain imaging studies show that psychedelics such as lysergic acid diethylamide (LSD), ketamine and psilocybin -- the psychoactive component in recreational drugs known as magic mushrooms -- act on the brain in ways that could help reduce symptoms of various psychiatric disorders.
The drugs could be used as a kind of catalyst, the scientists said, helping patients to alter their perception of problems or pain levels and then work with behavioral therapists or psychotherapists to tackle them in new ways.
"Psychedelics can give patients a new perspective -- particularly when things like suppressed memories come up -- and then they can work with that experience," said Franz Vollenweider of the Neuropsychopharmacology and brain imaging unit at Zurich's University Hospital of Psychiatry, who published a paper on the issue in Nature Neuroscience journal.
Depending on the type of person taking the drug, the dose and the situation, psychedelics can have a wide range of effects, experts say, from feelings of boundlessness and bliss at one end of the spectrum to anxiety-inducing feelings of loss of control and panic at the other.
LOW DOSES
Vollenweider and his colleague Michael Kometer, who also worked on the paper, said evidence from previous studies suggests such drugs might help ease mental health problems by acting on the brain circuits and neurotransmitter systems that are known to be altered in people with depression and anxiety.
But if doctors were to use them to treat psychiatric patients in future, it would be important to keep doses of the drugs low, and ensure they were given over a relatively short time period in combination with therapy sessions, they said.
"The idea is that it would be very limited, maybe several sessions over a few months, not a long-term thing like other types of medication," Vollenweider said in a phone interview.
A small study published by U.S. scientists this month found that an infusion of ketamine -- an anaesthetic used legally in both human and veterinary medicine, but also abused by people who use it recreationally -- can lift the mood within minutes in patients with severe bipolar depression.
Mental illnesses such as depression are a growing health problem around the world and Vollenweider and Kometer said many patients with severe or chronic psychiatric problems fail to respond to medicines like the widely-prescribed selective serotonin reuptake inhibitors, or SSRIs, like Prozac or Paxil.
"These are serious, debilitating, life-shortening illnesses, and as the currently available treatments have high failure rates, psychedelics might offer alternative treatment strategies that could improve the well-being of patients and the associated economic burden on patients and society," they wrote.
Source: Reuters
| | Oral alternative to allergy shots improves hay fever Tue 17th August 2010 | NEW YORK (Reuters Health) - A therapy that allows hay fever sufferers to get allergy shots in the form of a tablet or drops can help alleviate symptoms and cut people's reliance on allergy medication, a new research review confirms.
Known as sublingual immunotherapy, the treatment relies on the same principles as traditional allergy shots, but is delivered by tablets or drops that dissolve under the tongue.
Allergy shots may be used for hay fever when antihistamines and other allergy medications do not control a person's symptoms adequately, or for people who want to reduce their reliance on medication.
The shots help prevent hay fever symptoms by exposing people, over time, to small amounts of the pollen to which they are allergic, essentially desensitizing the immune system to the allergen.
Allergy shots are typically given weekly at first, followed by monthly injections over several years. The treatment does not cure hay fever but is generally effective at reducing symptoms. However, inconvenience and discomfort limits patients' willingness to try allergy shots.
Sublingual immunotherapy is an alternative and has become commonly used in Europe, where two tablet-based products against grass-pollen allergies are available: Grazax and Oralair. There are also a number of drop-based products. No sublingual immunotherapy products have yet been approved in the United States, however.
For the new study, reported in the Journal of Allergy and Clinical Immunology, Italian researchers combined the results of 19 clinical trials conducted since 1995 on the effectiveness of immunotherapy tablets and drops against hay fever caused by grass pollen.
The trials lasted anywhere from three months to three years.
Across the studies, which included a total of 2,971 adults and children with grass-pollen allergies, immunotherapy reduced symptoms by about 20 percent to 30 percent, on average. It also allowed patients to reduce their use of antihistamines and other medications.
The researchers, led by Dr. Gabriele Di Lorenzo of the University of Palermo, describe the benefits as "modest."
In an email, Di Lorenzo told Reuters Health that the findings suggest that sublingual immunotherapy is "highly effective in many, but not in all patients." He said that more work is needed to identify which patients might be most likely to benefit.
Dr. Harold Nelson, an allergist at National Jewish Health in Denver, said that the body of evidence indicates that sublingual immunotherapy beats antihistamines and other medications used to control hay fever symptoms.
In an interview, he noted that antihistamines reduce symptoms by about 12 percent to 15 percent, on average. Nasal steroids, another hay fever option, appear to cut symptoms by about 17 percent.
On the other hand, Nelson said, allergy shots appear to outperform the oral versions, with a symptom reduction about twice that of sublingual immunotherapy.
In addition, the long-term effectiveness of the grass-pollen tablets is not yet fully clear.
Like allergy shots, the oral immunotherapy takes time. Grazax, for instance, is taken daily, starting several months before the start of the next grass-pollen allergy season and continuing for three years thereafter.
Research so far suggests that the symptom relief persists in the year after patients stop taking Grazax. A study published earlier this year -- and not included in the current analysis -- found that during that post-treatment year, Grazax patients had one-quarter fewer hay fever symptoms than those who had been given a placebo for comparison.
But longer term data are not yet available. The benefits of allergy shots, by contrast, have been shown to persist for 10 years or beyond, Nelson noted.
The ultimate cost-effectiveness of sublingual immunotherapy has also yet to be determined; in the UK, for example, Grazax treatment costs about 2.25 pounds ($3.50) per day. In theory, that could pay off if long-term use of allergy medications was cut, but that has yet to be shown.
Still, Nelson said that if sublingual products do win approval in the U.S., they will likely boost the number of hay fever sufferers who want to use under-the-tongue immunotherapy. Even though the effectiveness is less than that of allergy shots, the convenience of an at-home version of immunotherapy is a plus, and the sublingual therapy tends to have fewer side effects than shots, according to Nelson.
The most common side effects include itchiness and irritation in the mouth, ears and eyes, swelling of the mouth or tongue, headache and gastrointestinal problems like stomach pain and heartburn.
SOURCE: http://link.reuters.com/sep35n Journal of Allergy and Clinical Immunology, online August 5, 2010.
| | Fish oil may curb depression among teen boys Tue 17th August 2010 | NEW YORK (Reuters Health) - Eating more oily fish like sardines, salmon and yellowtail could help teenage boys feel less blue, suggests a new Japanese study.
The same does not appear to hold for teen girls, however.
Omega-3 fatty acids, including EPA and DHA, are found predominantly in oily fish. Because these nutrients are thought to play a role in brain function, many researchers have wondered whether increased consumption could lower the risk of depression. But studies of such an association among adults have yielded inconclusive results.
Until now, investigators had yet to look for the potential link in youth, a population also prone to the debilitating problem. So Kentaro Murakami of the University of Tokyo and colleagues analyzed the diets and rates of depression in more than 6,500 Japanese junior high school students between the ages of 12 and 15.
Overall, 23 percent of the boys and 31 percent of the girls suffered from symptoms of depression, including feelings of worthlessness, hopelessness and sleep disturbances, they report in the journal Pediatrics.
Based on questionnaires of food intake, and adjusting for factors including age and parents' education level, the investigators found that boys who ate the most fish -- the top fifth based on total consumption -- had a 27 percent lower odds of being depressed compared to those ranked in the bottom fifth.
Similar differences were seen when looking specifically at the EPA and DHA content of the fish consumed.
Meanwhile, no effect of fish oil on depression was seen among the girls.
The investigators admit that the differing effect of fish oil between boys and girls is difficult to explain, although they point to a few possibilities such as a stronger genetic role for depression in women compared to men.
They also caution that their findings do not provide enough evidence to determine if fish oil actually lowers the risk of depression. It might be, for example, that those who are depressed eat less fish.
Although more research is needed to confirm a cause-and-effect link, the researchers conclude that boosting the intake of fish, EPA and DHA "may be an important strategy for the prevention of depression."
SOURCE: http://link.reuters.com/veh73n Pediatrics, September 2010.
| | Women beer drinkers 'increase psoriasis risk' Tue 17th August 2010 | Women who drink beer regularly are more likely to develop the skin disease psoriasis, a US study suggests.
The study found that women who drank five beers a week doubled their risk of developing the condition compared with women who did not drink.
The Boston study, in Archives of Dermatology, looked at more than 82,000 female nurses aged 27 to 44 and their drinking habits from 1991 until 2005.
Non-alcoholic beer, wine and spirits were not found to increase the risk.
In the study, researchers said they observed a 72% increased risk of psoriasis in women who drank more than 2.3 alcoholic drinks per week compared with non-drinkers.
For women who drank five glasses of beer per week their risk of developing psoriasis was 1.8 times higher again.
When stricter criteria were used to confirm psoriasis cases, their risk was increased 2.3 times.
Yet women who drank any amount of low- or non-alcoholic beer, white wine, red wine or spirits per week were not found to be at increased risk.
Barley content
Author Dr Abrar Qureshi, from Harvard Medical School, Boston, wrote in the journal: "Non-light beer was the only alcoholic beverage that increased the risk of psoriasis, suggesting that certain non-alcoholic components of beer, which are not found in wine or liquor, may play an important role in new-onset psoriasis."
The study suggests that it could be the gluten-containing barley, used in the fermentation of beer, which is the cause of the increased psoriasis risk.
Previous studies have shown that a gluten-free diet may improve psoriasis in patients who are sensitive to gluten.
People with psoriasis may have a so-called latent-gluten sensitivity, compared with people without psoriasis, says the study.
"Women with a high risk of psoriasis may consider avoiding higher intake of non-light beer," the authors conclude.
Psoriasis is a chronic skin disease characterised by itchy red scaly patches that most commonly appear on the knees, elbows and scalp but can show up anywhere, including the face.
The effects can range from mild to disfiguring enough to be socially disabling.
Source: BBC
| | Immune system gene linked with Parkinson's: study Mon 16th August 2010 | CHICAGO (Reuters) - A gene linked with the immune system may play a role in developing Parkinson's disease, researchers said on Sunday, marking a possible advance in the search for effective treatments.
They said a gene in the human leukocyte antigen region or HLA -- which contains a large number of genes related to immune system function -- was strongly linked with Parkinson's disease.
"That means the immune system probably plays a role in your body developing Parkinson's disease," said Dr. Cyrus Zabetian of the University of Washington and Veteran's Administration Puget Sound Health Care System, whose study appears in the journal Nature Genetics.
Zabetian said there had been hints that the immune system may be linked to Parkinson's disease, a neurodegenerative disease that affects 1 to 2 percent of people over age 65.
"This is the best evidence we've seen so far," Zabetian said in a telephone interview.
The finding came from a large, long-term study of more than 2,000 Parkinson's disease patients and 2,000 healthy volunteers from clinics in Oregon, Washington, New York and Georgia.
Parkinson's sufferers have tremors, sluggish movement, muscle stiffness and difficulty with balance.
Researchers looked at clinical, genetic and environmental factors that might contribute to the development and progression of Parkinson's disease and its complications.
"We found strong evidence that a gene within the HLA region is associated with Parkinson's disease," Zabetian said.
HLA genes play an important role in helping the body discern between foreign invaders and the body's own tissues.
"We don't know specifically which gene because there is a cluster of genes in that region, but it is the first really strong link that the immune system plays a role," he said.
That may mean infections, inflammation or an auto-immune response play some role in the development of Parkinson's disease, Zabetian said.
"What this allows us to do is to hone in on the immune system," he said.
Although current medical treatments may improve symptoms, none can slow or halt the progression of the disease.
The study was funded in part by the National Institute of Neurological Disorders and Stroke, one of the National Institutes of Health.
Source: Reuters
| | U.S. hopeful Pakistan can avert big cholera outbreak Mon 16th August 2010 | WASHINGTON (Reuters) - A senior U.S. aid official said on Saturday he was optimistic a serious cholera outbreak could be averted in flood-hit Pakistan after emergency steps taken by international and Pakistani relief groups.
At least one case of cholera was confirmed on Friday and several more were suspected, said Mark Ward, acting director of the U.S. Agency for International Development's office for foreign disaster assistance. Epic floods have affected more than 14 million people in Pakistan.
"The good news is that we know where it is and we can get resources in there to help because of the disease early warning system," said Ward, referring to a system set up by the World Health Organization to quickly detect any cases of cholera or other waterborne illnesses common in flooding.
"When you are dealing with this much water and that many people, it (cholera) is almost unavoidable," added Ward, who is in charge of coordinating USAID disaster relief efforts in Pakistan. "I think we can control this."
Cholera, a bacterial intestinal infection typically spread through contaminated water, causes severe diarrhea and dehydration and can be fatal.
The floods, triggered by torrential monsoon downpours, have engulfed Pakistan's Indus river basin, killing more than 1,600 people and wrecking crops and wiping out livestock.
A big issue in preventing more cases of cholera, said Ward, was ensuring that those suffering from the illness could be transported quickly to clinics set up to deal with waterborne diseases.
"We may well have to divert some air assets we have to transport people to treatment centers," he told Reuters in a phone interview, referring to helicopters sent by the United States to help with relief efforts.
The State Department said seven out of an additional 19 helicopters ordered by Defense Secretary Robert Gates earlier this week had arrived in Pakistan in support of flood relief efforts.
In addition, radio and text-messaging networks had been set up to get out information about the importance of good hygiene and washing hands, Ward said.
Aside from rescuing those stranded by the floods and dealing with a potential public health crisis, the United States is also planning rehabilitation efforts, including credit facilities and building materials to provide shelter for when people return to their villages.
"But that is all waiting for when the rains stop and people can get home," said Ward.
So far, the United States has given more than $75 million in financial and humanitarian assistance to help with flood efforts as well as helicopters.
Before the floods, the United States had committed $7.5 billion in nonmilitary aid for Pakistan over the next five years to cover a wide range of projects from infrastructure to water and electricity.
U.S. officials are looking at how some of that money might be reprogrammed to deal with immediate needs after the floods.
Source: Reuters
| | Woman's diabetes disappears after surgery Mon 16th August 2010 | Mary Writesel wrestled with obesity for a couple of decades, but it wasn't until she was diagnosed with diabetes that she considered a drastic solution: Weight-reduction surgery.
Even before she left the hospital after the surgery last August, her blood sugar levels had fallen so much she no longer needed medication for diabetes, high blood pressure and high cholesterol.
A year later and 60 pounds lighter, "I'm considered diabetes free," the 55-year-old Portsmouth resident said. "I can't tell you what a relief it is."
That by no means happens to all diabetics who go through weight-reduction surgery, but it happens enough that researchers are taking note.
Writesel agreed to donate a sample of fat removed during her surgery for a study being conducted by researchers at Norfolk's Eastern Virginia Medical School. "I told them they could have as much of that as they wanted."
The local medical school study is one of many exploring why diabetes sometimes goes away after weight-reduction surgery. At first, the phenomenon was chalked up to weight loss, but some patients were shedding the disease before losing a pound or even leaving the hospital.
Researchers at the EVMS Strelitz Diabetes Center decided to study different types of body fat to see whether certain aspects are more likely to result in problems such as diabetes and heart problems.
They're particularly interested in visceral fat — what most people refer to as belly fat — that surrounds internal organs. People with a lot of that type of fat are generally apple-shaped and are at higher risk for Type 2 diabetes and heart disease.
People who are pear-shaped tend to have fat that is under the skin — subcutaneous fat — that shows up in the hips, thighs and buttocks area.
The researchers are focusing on an enzyme in fat called lipoxygenase, which can cause inflammation that damages blood vessels. If they can determine how the enzyme causes the inflammation, that could lead to medical treatments to correct it.
Gastric bypass vs. 'lap-band' surgery
Dr. Jerry Nadler, director of the Strelitz center, said the study also wants to determine why patients who have gastric bypass surgery seem to be more likely to stop being diabetic than those who have "lap-band" surgery. Gastric bypass is a procedure that restricts the stomach so food bypasses part of the intestine; lap-band is less invasive, with a band placed on the upper part of the stomach to make it smaller.
Anca Dobrian, an assistant professor of physiological sciences at EVMS and lead author of the study, said fat samples from 34 people have been collected during the past year for the pilot study, which will eventually include 40. Half the patients will have had gastric bypass surgery, the other half the lap-band procedure. In each category, half are diabetic and half are not.
Samples of both belly fat and fat beneath the skin are being studied.
Dobrian said that so far the study is showing that the diabetics have certain enzymes that are different from non-diabetics, and that enzymes in the bloodstream change after gastric bypass surgery.
The initial results were presented at an American Diabetes Association conference in June, and they are intriguing enough that the researchers believe they can get more funding to expand the study.
Dr. Stephen Wohlgemuth, medical director at Sentara Norfolk General Hospital's weight-loss center, is working in conjunction with the researchers by collecting samples from his patients.
He's been doing weight-reduction surgery for a decade. He said many gastric bypass patients have gone home from the hospital without needing their diabetes medication, or stopped taking it within weeks of the surgery, even before they've lost much weight.
Across the globe, there have been other studies of weight-reduction surgery patients whose Type 2 diabetes disappeared after surgery. One study published in the Journal of the American Medical Association in 2004 found that 70 percent of 22,000 obese patients with diabetes had the disease go into remission after gastric bypass surgery. Some doctors are even recommending the surgery to diabetics who don't meet the usual requirements for weight-reduction surgery.
There are critics, however, who contend that people can manage diabetes through diet, exercise and medication rather than risk complications of surgery and the expense of hospitalization. People can also regain weight after surgery and become diabetic again.
Insurance companies require patients to have a certain body mass index, and health complications such as diabetes or heart disease, to qualify for weight-reduction surgery coverage.
Nadler said there is a lot of discussion among health experts about the best treatments for diabetes and obesity, and for good reason. The medical costs of obesity are estimated to be as high as $147 billion a year; the American Diabetes Association pegs the costs of diabetes at about $116 billion a year.
Nadler is hopeful that the EVMS study will provide some answers. Blocking the enzymes that cause inflammation could help stem the damage of diabetes and heart disease.
Changed diet, improved blood sugar
Writesel, an executive secretary at Sentara Norfolk General, had been on high blood pressure medication since she was 19, shortly after her father died of a massive heart attack. When she was 50, her cholesterol was high, so she added more medication for that.
She was diagnosed with diabetes three years ago.
"I was devastated," Writesel said. "I thought, 'I can't have one more thing go wrong with my body.' "
The diabetes medications brought her up to six to eight medications a day. By this time, she weighed 250 pounds.
Six months before her gastric bypass surgery she started classes to learn about nutrition and how to change her diet. By the time she had the surgery, she was down to 238 pounds, and her blood sugar levels were improving. Writesel was on a liquid diet for a week before the surgery and was taking her diabetes medication up until a few days before her surgery.
That was the last time she took it. As soon as she came home from the surgery, she felt more energetic. She's lost 60 more pounds and wants to lose another 30. She walks two miles a day.
Instead of needing to see her primary care doctor every three months, she was advised to come back in a year.
"You don't know how good that sounded," Writesel said.
'Push away from the table'
Audrey Floyd, 54, is another participant in the study. The Virginia Beach woman had lap-band surgery in May because the procedure did not require her to take as much time off work as gastric bypass. She's lost 10 pounds so far. She still has diabetes, but she is hopeful it will fade away as she loses more weight.
She said her primary care doctor didn't recommend the weight-reduction surgery but suggested instead that she "push away from the table."
Floyd hopes the fat she donated to the study will help other people like her: "Diabetes runs in my family. We are all getting it as we get older."
Source: MSNBC News
| | Supplement may help people with depression Sat 14th August 2010 | NEW YORK (Reuters Health) - A small study suggests that a nutritional supplement sold over-the-counter may help some people with depression who haven't gotten better with any other drugs.
Researchers found that adding the supplement, called S-Adenosyl Methionine, or SAMe, to a patients' antidepressant treatment helped more people with major depression improve their symptoms than those that took an inactive placebo on top of their normal medication.
The supplement also had fewer side effects than medications that are approved by the FDA for people with depression who don't respond to antidepressants.
"This is an exciting, yet preliminary finding," Dr. George Papakostas, the study's lead author and a psychiatrist at Harvard Medical School and Massachusetts General Hospital, Boston, told Reuters Health.
At some point in their lives, up to 10 percent of people will suffer from major depressive disorder, defined as at least two consecutive weeks with multiple symptoms of depression, Papakostas said. About half of those people won't get better, even after trying a few different antidepressants, he said.
While there are a few medications approved by the FDA that these patients can take in addition to standard antidepressants, those drugs - called atypical antipsychotics - can have serious and sometimes life-threatening side effects, Papakostas said.
In the current study, which is published in the American Journal of Psychiatry, Papakostas and his colleagues gave SAMe to 39 people who had major depressive disorder that hadn't gotten better on antidepressant therapy. These people took 1600 milligrams of SAMe each day in addition to the antidepressant treatment they were on before the study started. Thirty-four similar patients took a placebo pill on top of their antidepressants. Neither group knew which treatment they had.
The authors then used two standard tests for depression to measure patients' symptoms each week for the next six weeks.
About a quarter of patients in the study dropped out because they weren't getting better or didn't feel well on SAMe or the placebo. But SAMe had no serious side effects, and a similar number of patients stopped the study because they didn't like SAMe and because they didn't like the placebo.
Among the 31 patients taking SAMe and the 24 taking placebo that completed the full six-week study, both depression tests showed that more patients on SAMe than on placebo responded to treatment and got better.
Previous studies have shown that SAMe can influence chemicals in the brain and might work as an antidepressant on its own or interact with traditional antidepressants, but the way it works isn't completely clear.
SAMe is found naturally in the human body and is sold as a supplement by vitamin stores. But it's more expensive than many current antidepressants, said Dr. Raymond Lam, the director of Mood & Anxiety Disorders at The University of British Columbia, who studies SAMe. The treatment will probably run more than $100 a month he said, and it's unclear whether it could be covered by insurance in the future.
The authors say that long-term studies will be needed to see if SAMe is as effective in helping patients with major depressive disorder as their results suggest.
The finding, Papakostas said, "is exciting because (SAMe) works differently than what we have now -- it doesn't seem to be associated with the kind of side effects that FDA-approved treatments for this niche have." But, he said, "like other findings in medicine, it needs to be replicated."
Lam agreed. "We're always careful about these small studies," he told Reuters Health. "Depression is a complicated condition. We don't know exactly what works for which people, and so it is important that people don't rush out and stop taking whatever they're taking in order to use a new treatment."
The study was funded by the National Institute of Mental Health and both SAMe and placebo pills were provided by the dietary supplement company Pharmavite, which markets SAMe.
SOURCE: http://link.reuters.com/nan52n American Journal of Psychiatry, published online July 1, 2010.
| | Obese visit GP more often than smokers, researchers say Sat 14th August 2010 | Overweight people are more likely to make frequent trips to their GP than smokers or those who are generally unfit, say Dutch researchers.
The findings cannot be explained by overweight people having a higher risk of chronic diseases, such as diabetes, the analysis showed.
Rising rates of obesity means nurses may have to take some of the pressure off doctors, they said.
The research is published in Family Practice.
The team from Maastricht University looked at GP data from almost 4,500 adults.
Participants also filled in a questionnaire designed to find out about their lifestyles, such as their diet, whether they smoked, how much they drank and how much exercise they did.
They expected to find that the most unhealthy or unfit people would visit their GP more often.
But of the lifestyle factors looked at, only body mass index (BMI) was independently associated with frequent visits to the doctor.
The finding was true of both men and women and was not accounted for by higher rates of chronic illness.
Minor complaints
Although the researchers could not conclude from the study why overweight people may visit their GP more often, they speculated they may have more minor complaints, such as sleep problems or musculoskeletal pain.
Study leader Dr Marjan van den Akker said further work was needed to unpick the reasons for frequent attendance.
And she added that GPs would come under increasing pressure as obesity becomes more common and other ways of managing demand may need to be considered.
"The role of the nurse practitioner is already common in diabetic patients, chronic lung disease and the elderly, so it's very feasible that they could take on this role."
Dr David Haslam, a GP and chair of the National Obesity Forum, said the results certainly reflected what he saw in his practice.
"It's good news that they are worried about their health and want checking out but we also know that we have to do more to identify and manage overweight patients.
"Practice nurses are the mainstay of treating these patients because they can spend longer with them and have the opportunity to give lifestyle advice."
Source: BBC
| | HM Government petition response Fri 13th August 2010 | Petition to:
regulate the practice of Chinese herbal medicine in the UK
This petition is now closed, as its deadline has passed.
We the undersigned petition the Prime Minister to regulate the practice of Chinese herbal medicine in the UK. More details
Submitted by Emma Farrant of Register of Chinese Herbal Medicine – Deadline to sign up by: 06 June 2010 – Signatures: 1,496
More details from petition creator
At present, anyone can call themselves a Chinese medicine practitioner and treat the public. They do not have to be qualified or competent and yet they have access to powerful herbal medicines.
In February 2010, the Old Bailey heard how a civil servant suffered cancer and kidney damage after taking a banned medicine sold by a Chinese medicine shop. The regulation of Chinese medicine practitioners would protect the public from such cases of malpractice.
Despite widespread support for regulation, the government has failed to act. Regulation would ensure that all practitioners are trained to national standards and have professional insurance.
From April 2011, a new EU law will mean that even fully qualified Chinese medicine practitioners will lose access to the majority of the herbs and medicines on which they rely. Many herbs and medicines will only be available to medical professionals who are regulated by the government, such as GPs. Many practitioners will go out of business, and many patients will not be able to receive the treatment that they need. The government can prevent this by granting statutory regulation to Chinese medicine practitioners.
http://petitions.number10.gov.uk/regulateCHM/
Government response
The issue for this new Government is to establish whether statutory regulation is the most appropriate way of dealing with risks posed by unskilled or unscrupulous practitioners, or if a “lighter-touch” approach would be more appropriate.
Last year, the Department of Health, along with the devolved health Departments, consulted on the regulation of practitioners of acupuncture, herbal medicine and traditional Chinese medicine. The consultation closed in November 2009, and more than 6,500 responses were received. The high response rate is a testament to the strength of feeling about public access to complementary and alternative medicines.
The consultation examined in detail the options for regulation, including alternatives to statutory regulation. Once the Government has considered the consultation responses, it will make clear the next steps in the regulatory process.
Source: HM Government
| | Herbal remedy for digestive disorder Fri 13th August 2010 | Nikki Page finds her life is transformed when she discovers a cure for her chronic digestive disorder.
Nikki Page can now eat whatever she likes, without suffering discomfort.
A bloated and upset stomach. Multiple sensitivities and allergies to a large number of foods. Fatigue. Acid reflux. Lethargy. Pains in muscles and joints. Does any of this sound familiar? For nearly 40 years, I struggled to cope with a digestive system that never seemed to work.
Eating out was a nightmare, but not as bad as trying to explain to my wonderful friends that there was virtually nothing they could cook that I could eat. I could never have a glass of wine or a piece of cake without really suffering. A hint of egg yolk would leave me in the bathroom for days (a reaction that wrecked several supposedly romantic weekends). Sometimes I was so exhausted by making my morning cup of tea that I had to lie down before I could drink it.
In my teens, I went to the doctor with what he thought was a regular stomach bug. He prescribed a supposed wonderdrug called Septrin to kill it off. While it had no discernible effect on the bug, it very nearly killed me. My eyes and nails bled, I was ulcerated inside and out. I could not see for days and doctors feared permanent damage to my kidneys. Family was called to the bedside, and I was months recovering and convalescing.
Not long after supposedly being better, the eating and stomach problems began. I often felt as though I was several months’ pregnant, and uncomfortable to the point of dreading eating anywhere but home. Then there were the inexplicable muscle aches and pains. My niece laughed at me when I said that if I ate a strawberry, I would feel an immediate twinge in my toe. The list of foods to avoid to counter the multiple allergies I had developed grew ever longer.
There followed a series of particularly unpleasant tests but no diagnosis. I assumed that the stomach pains were a result of damage done to my intestines by the antibiotics. There was even a suggestion that perhaps it was psychosomatic.
Life improved a bit when my American husband introduced me to an exceptional doctor in his home town of Wichita. Dr Riordan, who specialised in developing alternative treatments for chronic illnesses, was the first to identify the presence of parasites in my blood. With various treatments and a strict diet, he made my life bearable again. But the stomach problems never really went away. I just learned to control and live with them.
Over time, bad bouts would come back more frequently. As well as the original symptoms, I suffered regularly with candida, while my diet became so restricted that eating out anywhere was a real challenge. In addition, I needed plenty of rest and endless supplements to lead a half-normal life.
Wary of conventional medicine, I turned to anyone other than doctors. I tried everything – nutritionists, acupuncture, and any number of different clinics – but still the symptoms continued. All of them thought they could cure me: none did. On top of everything else, I was spending a fortune on supplements just to keep functioning.
Then a young friend of mine who had recently come back from India was experiencing similar problems. Tests revealed that she had contracted Giardia, a type of gastro-enteritis caused by Giardia lamblia, a microscopic parasite which the World Health Organisation classifies as one of the most common affecting humans. It can be transferred through polluted water or contact with animals such as dogs, and reproduces in the small intestine.
Nervous of the traditional cure – such infections are conventionally treated with a broad spectrum antibiotic – she was recommended instead to an alternative therapist. One week after her first visit to Susan Koten, a renowned nutritionist in Essex, and I could not believe how well she looked.
Having explored every other medical option for my own stomach troubles, I decided to try a herbalist myself.
It is not an exaggeration to say that Susan transformed my life. She identified that I too had contracted Giardia lamblia. Once infected, symptoms can occur within 24 hours as it multiplies and starts excreting and secreting waste products into your body. These by-products can trigger an allergic response, causing hypersensitivity to certain foods as well as a host of other problems, including nausea and depression.
Susan gave me a herbal tincture – at £18 a bottle – to take three times a day for a week, the main ingredient of which was wormwood. I felt better almost immediately. When I returned a week later for a check-up, she decided that I needed another course to be sure the parasite was completely gone.
And that was it. I am truly a changed person. I have more energy than ever. I am no longer permanently bloated or spend half my life in the bathroom. I can have a glass of wine, eat out without worrying and really enjoy it. I can visit friends without the embarrassment of rattling off a list of foods I cannot touch. This summer, I ate strawberries without pain for the first time in years.
It is almost impossible to explain how life-transforming it is not to be dealing with a chronic illness the whole time. Of course, it could come back and I am extra-diligent about washing my hands before touching food. I still eat healthily and avoid vast quantities of alcohol. But I was able to sit outside a lovely café in the sunshine last week – and eat a very large chocolate bun.
Source: Daily Telegraph
| | Chinese Hospitals Are Battlegrounds of Discontent Fri 13th August 2010 | SHENYANG, China — Forget the calls by many Chinese patients for more honest, better-qualified doctors. What this city’s 27 public hospitals really needed, officials decided last month, was police officers.
A police vehicle at the hospital last month. Shenyang reported 152 “severe conflicts” between patients and doctors last year.
Slogans on banners at China Medical University Hospital No. 1 call for harmonious relations between doctors and patients.
Dissatisfaction with medical care is common in the city and across China.
And not just at the entrance, but as deputy administrators. The goal: to keep disgruntled patients and their relatives from attacking the doctors.
The decision was quickly reversed after Chinese health experts assailed it, arguing that the police were public servants, not doctors’ personal bodyguards.
But officials in this northeastern industrial hub of nearly eight million people had a point. Chinese hospitals are dangerous places to work. In 2006, the last year the Health Ministry published statistics on hospital violence, attacks by patients or their relatives injured more than 5,500 medical workers.
“I think the police should have a permanent base here,” said a neurosurgeon at Shengjing Hospital. “I always feel this element of danger.”
In June alone, a doctor was stabbed to death in Shandong Province by the son of a patient who had died of liver cancer. Three doctors were severely burned in Shanxi Province when a patient set fire to a hospital office. A pediatrician in Fujian Province was also injured after leaping out a fifth-floor window to escape angry relatives of a newborn who had died under his care.
Over the past year, families of deceased patients have forced doctors to don mourning clothes as a sign of atonement for poor care, and organized protests to bar hospital entrances. Four years ago, 2,000 people rioted at a hospital after reports that a 3-year-old was refused treatment because his grandfather could not pay $82 in upfront fees. The child died.
Such episodes are to some extent standard fare in China, where protests over myriad issues have been on the rise. Officials at all levels of government are on guard against unrest that could spiral and threaten the Communist Party’s power.
Doctors and nurses say the strains in the relations between them and patients’ relatives are often the result of unrealistic expectations by poor families who, having traveled far and exhausted their savings on care, expect medical miracles.
But the violence also reflects much wider discontent with China’s public health care system. Although the government, under Communist leadership, once offered rudimentary health care at nominal prices, it pulled back in the 1990s, leaving hospitals largely to fend for themselves in the new market economy.
By 2000, the World Health Organization ranked China’s health system as one of the world’s most inequitable, 188th among 191 nations. Nearly two of every five sick people went untreated. Only one in 10 had health insurance.
Over the past seven years, the state has intervened anew, with notable results. It has narrowed if not eliminated the gap in public health care spending with other developing nations of similar income levels, health experts say, pouring tens of billions of dollars into government insurance plans and hospital construction.
The World Bank estimates that more than three in four Chinese are now insured, although coverage is often basic. And far more people are getting care: the World Bank says hospital admissions in rural counties have doubled in five years.
“That is a steep, steep increase,” said Jack Langenbrunner, human development coordinator at the World Bank’s Beijing office. “We haven’t seen that in any other country.”
Still, across much of China, the quality of care remains low. Almost half the nation’s doctors have no better than a high school degree, according to the Organization for Economic Cooperation and Development. Many village doctors did not make it past junior high school.
Primary care is scarce, so public hospitals — notorious for excessive fees — are typically patients’ first stop in cities, even for minor ailments. One survey estimated that a fifth of hospital patients suffer from no more than a cold or flu. Chinese health experts estimate that a third to a half of patients are hospitalized for no good reason.
Once admitted, patients are at risk of needless surgery; for instance, one of every two Chinese newborns is delivered by Caesarean sections, a rate three times higher than health experts recommend.
Patients appear to be even more likely to get useless prescriptions. Drug sales are hospitals’ second biggest source of revenue, and many offer incentives that can lead doctors to overprescribe or link doctors’ salaries to the money they generate from prescriptions and costly diagnostic tests. Some pharmaceutical companies offer additional under-the-table inducements for prescribing drugs, doctors and experts say.
An article in November in The Guangzhou Daily in southeastern China cited one particularly egregious example of unnecessary treatment: a patient paid roughly $95 for a checkup, several injections and a dozen different drugs, including pills for liver disease. He had a cold.
The Health Ministry has ordered hospitals to reduce prices of specific drugs 23 times in a decade, but the World Bank says hospitals have responded, in part, by ordering higher-priced alternatives.
Some experts fear that the newly opened spigot of government insurance money will inspire further excesses, rather than reduce the financial risk of illness for most Chinese. Indeed, one study shows only a slight drop in the share of household spending devoted to health care — 8.2 percent in 2008, down from 8. 7 percent in 2003.
“Their protection may not really be improving with insurance,” said Mr. Langenbrunner of the World Bank. “That is the scary part.”
Doctors seem as unhappy as patients. They complain that they are underpaid, undervalued and mistrusted. One in four suffers from depression, and fewer than two of every three believe that their patients respect them, a survey by Peking University concluded in October.
In June, more than 100 doctors and nurses in Fujian Province staged their own sit-in after their hospital paid $31,000 to the family of a patient who died. The doctors were upset because after the patient died the relatives took a doctor hostage, setting off a bottle-throwing melee that injured five employees.
Like some other cities, Shenyang has been seeking ways to ward off disturbances, including setting up hospital mediation centers. Still, the city reported 152 “severe conflicts” between patients and doctors last year.
At Hospital No. 5, the memory of a January attack remains fresh. After a doctor referred a patient with a temperature to a fever clinic — standard practice in China — frustrated relatives beat the doctor and several nurses with a mop and sticks.
Now a banner strung across the hospital’s main lobby exhorts: “Everyone participate in the sorting out of the law and order problem!”
Source: New York Times
| | What do food allergy labels really mean? Thu 12th August 2010 | NEW YORK (Reuters Health) - While you might be tempted to ignore those "made in a facility that processes" (something you're allergic to) labels in the supermarket, new research suggests products with these labels are in fact more likely to be contaminated with peanuts, milk or eggs than unlabeled foods.
"Our study underscores the need for allergic consumers to avoid advisory-labeled products, which present a small but real risk," the authors write in the study, which is published as a letter to the editor in the Journal of Allergy and Clinical Immunology.
According to the Centers for Disease Control and Prevention, 2 percent of U.S. adults and 4 to 8 percent of kids have food allergies, which cause about 150 deaths each year. People with allergies vary in the severity of their reactions - some will get a mild rash or an itchy tongue if they eat something that contains the allergen; others may stop breathing and lose consciousness.
While companies are required to clearly state if their products have possible allergens in the ingredient list, there are no particular regulations on whether they need to add statements such as "may contain traces of peanuts," for example, for foods that aren't supposed to contain such allergens.
"It's kind of their own individual perception about what level of risk warrants the warning," Dr. Lara Ford, the study's lead author and an allergist at the Mount Sinai School of Medicine in New York, told Reuters Health. "It may not even enter the consciousness at some companies."
Ford and her colleagues analyzed 401 foods from supermarket shelves, ranging from baking mixes to pasta. Of these, 228 had labels warning consumers that they could be contaminated with peanuts, milk, or eggs, while other, similar foods had no labels listing possible allergens. The researchers tested all of the products to see if they were contaminated with whichever of the three allergens they suspected each one could contain.
About 5 percent of foods with warning labels had traces of allergens, compared to 2 percent of foods without labels. In all, 5 out of 232 products the authors tested were contaminated with peanuts, 10 out of 193 with milk, and 4 out of 174 with eggs.
The highest levels of contamination they found were 5.8 milligrams per serving for peanuts, 7.3 mg per serving for milk, and 0.26 mg per serving for eggs. Because there is not a lot of data about what traces of these ingredients are okay for people with allergies, the authors didn't know if these levels would be dangerous.
Products from smaller companies were also about seven times more likely to be contaminated with allergens than products made by larger companies. Small manufacturers, Ford said, "probably are using the same equipment for multiple different products," which increases the chance of contamination. They also might have fewer resources to devote to cleaning products, she said.
The researchers say their findings don't necessarily apply to all foods you would find in the supermarket, but they are still cause for concern for people with allergies. To be safe, Ford said she recommends these people avoid products with warning labels for allergens. They can go farther by purchasing products only made by large companies, she added.
The study was funded by the Food Allergy Initiative, which is supported in part by the U.S. National Institute of Allergy and Infectious Diseases.
A spokesperson from the National Confectioners Association, which represents candy-making companies, agreed that foods labeled with certain warning statements should be avoided. "If a product is labeled that it 'may contain' the specific allergen to which the consumer is allergic, our strong advice is that the allergic consumer should not eat that product," Susan Smith told Reuters Health by email.
"Such statements are the industry's way of telling the allergic consumer that despite our best efforts to produce a candy free of unintentional allergens, the particular candy in question is not a good choice for them if they are allergic to the allergen mentioned."
More research also needs to be done to find out what level of contamination is actually harmful to people with allergies, Ford said, as this could guide labeling decisions. "We want there to be sensible guidelines about levels that are likely to provoke reactions," she said. "We want to have safe foods for allergic people that are as least restrictive as possible."
SOURCE: http://link.reuters.com/vez93n Journal of Allergy and Clinical Immunology, published online July 12, 2010.
| | Obesity linked to lower sperm count in young men Thu 12th August 2010 | NEW YORK (Reuters Health) - Young men who are obese may have a lower sperm count than their normal-weight counterparts, a new study suggests.
The findings, reported in the journal Fertility and Sterility, add to evidence tying obesity to relatively poorer quality sperm.
A number of recent studies have found that compared with leaner men, obese men tend to have lower sperm counts, fewer rapidly mobile sperm and fewer progressively motile sperm, which refers to sperm that swim forward in a straight line rather than moving about aimlessly.
But age is a "confounding" factor in examining the relationship between obesity and sperm quality. Older men tend to have lower sperm quality than younger men, and they also tend to have more body fat.
However, among the more than 2,000 men in the current study, obese men between the ages of 20 and 30 generally had a lower sperm count than normal-weight men in the same age group.
What all of this might mean for an obese younger man's chances of becoming a father is unclear. Studies have so far come to conflicting conclusions as to whether obesity actually impairs a man's fertility.
And these latest findings do not reveal whether the difference in sperm count between obese and normal-weight men would be enough to also make a difference in their fertility, according to lead researcher Dr. Uwe Paasch, of the University of Leipzig in Germany.
For their study, Paasch and his colleagues used information from a database on men who had come to their fertility clinic for a semen analysis between 1999 and 2005. The 2,157 men included in the study were 30 years old, on average, and had no known infertility problems.
Overall, obese men had a relatively lower average sperm count than normal-weight men, but were still within what's considered the normal range. That range is between 20 and 150 million per milliliter of semen, according to the National Institutes of Health.
In an email, Paasch told Reuters Health that "we do not know in detail" whether the difference in sperm count between obese and lean men would affect their fertility. But, he added that the relationship between weight and sperm count offers young men another reason to try to maintain a normal weight.
It is not entirely clear why obesity is related to sperm quality. Some studies have found that obese men tend to have altered levels of testosterone and other reproductive hormones compared with thinner men. In this study, though, hormone levels correlated with age, but not with body weight.
In other research, Paasch noted, he and his colleagues have found that high levels of body fat are associated with changes in the collection of proteins that allow sperm to survive and function.
The current study had a number of limitations, including the fact that the men were patients at a fertility clinic rather than a sample from the general population.
The researchers also point out that weight categories were based on body mass index, or BMI, a measure of weight in relation to height. The problem is that BMI does not precisely reflect a person's level of body fat.
Other studies have suggested that body fat, and abdominal fat in particular, is more closely related to sex-hormone levels than is BMI.
SOURCE: http://link.reuters.com/fyj54n Fertility and Sterility, online July 29, 2010.
| | UK, Iceland lead fall in Europe breast cancer deaths Thu 12th August 2010 | LONDON (Reuters) - Death rates from breast cancer have fallen markedly in Europe in the past 20 years thanks largely to better screening and treatment policies, with Britain and Iceland leading the way, scientists said on Thursday.
Researchers led by Philippe Autier from the International Prevention Research Institute in France looked at changes in breast cancer death rates in women in 30 European countries from 1989 to 2006 and found rates fell by around a fifth on average.
But breast cancer mortality in central European countries remained stable or in some cases rose, and the scientists said more efforts were needed to improve diagnosis and treatment to "reduce the avoidable breast cancer mortality" there.
Changes in breast cancer mortality ranged from a 45 percent decline in Iceland to a 17 percent increase in Romania, the scientists said in a study in the British Medical Journal.
England and Wales, Northern Ireland, and Scotland, had the second, third, and fourth largest decreases of 35 percent, 29 percent and 30 percent.
"Changes in breast cancer mortality after 1988 varied widely between European countries, and the UK is among the countries with the largest reductions," they wrote.
Experts commenting on this study, which used World Health Organization data on death rates, said it was more reliable than others that looked at cancer survival rates, since they could be skewed by changes in the number of cases of a disease.
Breast cancer kills around half a million people worldwide each year and is the most common type of cancer in women in wealthy nations.
Autier's team said countries with large declines in death rates, such as the Britain, had benefited from comprehensive and organized screening programmes, and rapid and general use of the generic breast cancer drug tamoxifen as well as chemotherapy.
"At the other end of the spectrum, in central European countries the small decreases or the continued increase in breast cancer mortality were correlated with low, usually non-organized, screening activities, low numbers of mammography machines, slow uptake of anti-cancer drugs, and health expenditures below the European average," they wrote.
But the researchers also noted that in some countries, such as France, Sweden and Finland, where health spending is relatively high and the focus on breast cancer screening and treatment had been good, death rates were falling less sharply than might have been hoped.
"The decline in breast cancer mortality in France has been quite modest despite this country having one of the highest number of mammography units per million women, having the highest spending on cancer drugs per person in Europe, being at the forefront in use of new costly treatments, and devoting much effort to enhancing adherence to guidelines," they wrote.
Breast cancer deaths rates declines in Finland, France, and Sweden were 12 percent, 11 percent and 16 percent respectively.
Source: Reuters | | FDA warns Singapore maker of Tiger Balm products Wed 11th August 2010 | WASHINGTON (Reuters) - Singapore-based Haw Par Corporation Ltd, the maker of Tiger Balm, failed to adequately test its healthcare unit's over-the-counter products, the U.S. drug regulator said in a warning letter made public on Tuesday.
The company's subsidiary, Haw Par Healthcare Ltd, misbranded its Tiger Balm pain-relieving patch, which qualifies as a drug and must be approved, the regulator said.
The warning letter from the U.S. Food and Drug Administration, dated July 20, follows an FDA inspection of the healthcare unit's manufacturing facility in October 2009.
Agency inspectors found that employees were untrained, control procedures were not followed, and laboratory tests had incomplete data, the FDA said.
The company's failure to correct the violations could result in blocking the products, the FDA wrote in the letter, released on the agency's website at http://link.reuters.com/kyr34n.
Representatives for Haw Par could not be immediately reached for comment.
The company's dominant market is Asia, with nearly $42 million in sales of Tiger Balm and Kwan Loong brand products in 2009, according to its annual statement. The company had $10.5 million in sales in its America region.
Source: Reuters
| | Breath test may be able to detect common cancers Wed 11th August 2010 | LONDON (Reuters) - An "electronic nose" could be used as a simple breath test to detect lung, breast, bowel and prostate cancers, Israeli scientists said Wednesday.
Using the sensor to pinpoint chemical variations, the team found they could not only distinguish between healthy and malignant breath but also identify the four different common tumor types.
While more work is needed to develop the technology, the early success could lead to the development of a cheap, easy-to-use and portable test to help diagnose cancer earlier.
"If we can confirm these initial results in large-scale studies, this new technology could become a simple tool for early diagnosis of cancer along with imaging," said Abraham Kuten of Technion Israel Institute of Technology.
Kuten and his colleagues studied the breath of 177 people -- some healthy and some with various types of cancer -- to detect the different chemicals emitted from the surface of cancer cells as they grow.
Their findings, published in the British Journal of Cancer, build on earlier research published by scientists at the same institute last year showing that a sensor made with gold nanoparticles could detect lung cancer in breath.
Source: Reuters
| | ED supplement causes 'worrisome' heartbeat changes Wed 11th August 2010 | NEW YORK (Reuters Health) - Enzyte, a popular dietary supplement marketed for "male enhancement," causes electrical abnormalities in the heart that could be potentially fatal in some people, new research suggests.
Doctors should tell their patients not to use the product until more safety information is available, Dr. Brian F. McBride of Loyola University Chicago in Maywood, Illinois, and his colleagues conclude. Vianda, the Cincinnati-based company that makes Enzyte, did not respond to calls or emails seeking comment.
According to Vianda's Web site, Enzyte promotes "firmer, stronger, fuller-feeling erections." The company also states that "over 5 million men worldwide" use the supplement.
Because Enzyte is regulated as a dietary supplement, the company is not required to provide data to back up claims of its effectiveness.
Under U.S. law, dietary supplements are also "'presumed safe unless proven to be otherwise,'" Dr. Paul Shekelle of RAND Health in Santa Monica, California, notes in an editorial accompanying the study, which is published in the Archives of Internal Medicine.
After being given the supplement, men in the study showed a prolongation of a section of the heart's electrical cycle known as the QT interval. For people with a condition called long QT syndrome, which may occur in as many as one in 2,000 people, further prolongation like that seen in the current study could lead to severe heart arrhythmia and sudden death.
"Enzyte appears to have some of the properties of some of the most powerful heart controlling medications that we give by prescription," McBride told Reuters Health.
McBride and his team had nine healthy young men take either a placebo, the equivalent of half a tablet of Enzyte, a whole tablet, or two tablets, and then performed an EKG one, three, and five hours later.
With the single-tablet dose, the researchers found, the men's QT intervals increased by an average of about 8 percent, or 32 milliseconds, three hours after they took the drug; at five hours, it had increased by 11 percent, or 37 milliseconds. No patients developed abnormal heart rhythms or prolonged erections, but four developed skin flushing.
Reports of sudden death in users of cisapride (the ulcer drug Propulsid) and terfenadine (the antihistamine Seldane), which prolonged QT intervals by an average of 13 and 17 milliseconds, respectively, prompted the Food and Drug Administration to pull these products off the market, the researchers point out.
Determining the risks of dietary supplements can be extremely difficult, notes McBride, especially those that are marketed for an "embarrassing" condition like impotence. Many men using these supplements don't want to tell their doctor, he added, so adverse effects may go unreported.
"This creates a relatively anonymous patient population at an elevated risk for drug-induced sudden death," he and his colleagues write.
Enzyte's ingredients include niacin, copper, zinc, ginseng, Ginkgo biloba, "horny goat weed standardized extract," and several other herbal components, according to the company's Web site. While the flushing seen in some of the men could be related to niacin, McBride and his colleagues write, it's impossible to say which substances might be responsible for prolonging QT intervals.
Another concern, the researchers note, is the fact that men taking the supplement in the real world are likely to be older and sicker than the young men in the study, which means they may already be at higher risk for heart arrhythmias.
In his editorial, Shekelle calls the findings "worrisome," but notes that the researchers did not look at actual adverse outcomes in patients, just EKG changes that may or may not lead to "serious health outcomes."
Nevertheless, he adds, "their conclusion that clinicians should advise their patients to avoid this dietary supplement until more evidence is available seems justified and prudent."
SOURCE: http://link.reuters.com/zut34n Archives of Internal Medicine, August 9/23, 2010.
| | Little evidence antidepressants helpful for autism Tue 10th August 2010 | NEW YORK (Reuters Health) - While antidepressants are commonly given to people with autism, there is no evidence from clinical trials that the drugs are helpful for children with the disorder, and only limited evidence that they benefit adults, a new research review finds.
The analysis, reported in the Cochrane Database of Systematic Reviews, adds to doubts about the use of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) in autism.
Last year, a U.S.-government-funded study found that the SSRI citalopram (Celexa) was no better than a placebo at improving repetitive behaviors in children with autism. At the time, experts expressed surprise at the lack of benefit and said the results illustrated the need to test antidepressants against placebos in people with autism.
For the new review, researchers evaluated the findings of the Celexa study, along with those of six other -- much smaller -- clinical trials in the medical literature.
Overall, they found no evidence that SSRIs were better than placebos at improving repetitive behaviors or other symptoms in children with autism. And there was only limited evidence from two small clinical trials that certain SSRIs might improve anxiety, depression and other symptoms in autistic adults.
On the whole, there is no basis for recommending the routine use of SSRIs in treating autism, according to the researchers, led by Dr. Katrina Williams, a pediatrician at the University of New South Wales and Sydney Children's Hospital in Australia.
However, the researchers are not recommending that people with autism who are already on an SSRI and doing well stop taking their medication.
As it stands, no medications are specifically approved for treating autism spectrum disorders (ASDs), a group of developmental disorders that hinder people's ability to communicate and build relationships. The conditions range from severe cases of "classic" autism to the relatively mild Asperger's syndrome.
Behavioral and educational therapies that target the social, developmental and communication problems are the mainstay of autism treatment. But SSRIs are often prescribed to aid with certain symptoms; by one estimate, up to 40 percent of children with autism have been treated with an antidepressant.
In the U.S., three SSRIs - sertraline (Zoloft), fluoxetine (Prozac) and fluvoxamine (Luvox) -- are FDA approved for children older than seven.
Part of the rationale for SSRI use in ASDs is that the drugs can be effective for anxiety and obsessive-compulsive disorder, conditions whose features are similar to some behaviors seen in autism. For example, repetitive behaviors -- such as repeating specific words or actions, or obsessively following a routine or schedule -- are a main feature of autism.
In addition, SSRIs enhance levels of the brain chemical serotonin, and serotonin is thought to influence sleep, mood, aggression and other brain processes that are often altered in autism, Williams told Reuters Health in an email.
But few clinical trials have been done to test the drugs' effectiveness in improving the symptoms of children or adults with autism.
Williams and her colleagues were able to find only seven small, short-term trials where people with autism were randomly assigned to take an SSRI or a placebo for comparison.
The Celexa study, by far the largest, included 149 children with ASDs who were given either the SSRI or a placebo for three months. Roughly one-third of the children in each group showed improvements in repetitive behaviors during the study period, with no advantage from the antidepressant.
All of the other studies Williams and her colleagues found were quite small, with the largest including 39 children. None went beyond three months.
Overall, the five studies that focused on children and teenagers showed no benefits of SSRI treatment, according to the researchers; the trials tested the drugs fluoxetine, fluvoxamine, and, in the two oldest studies, fenfluramine -- a medication that has since been pulled from the U.S. market.
Two studies included adults, with one testing fluoxetine and the other fluvoxamine. The trials found improvements in SSRI users' obsessive behaviors, anxiety, depression and aggression versus placebo users. However, the studies were very small -- one included six participants, the other 30 -- and treatment lasted eight to 12 weeks.
Moreover, SSRIs can have side effects, and concerns about adverse effects are greater with children and teens. In the citalopram study, one child given the drug developed seizures that required hospitalization, and continued to have repeat seizures after being taken off the drug. Children on the drug were also more likely than placebo users to show impulsive behavior, sleep problems and difficulty concentrating.
No increased risk of side effects was seen in children given Prozac; the study that looked at Luvox provided little information on side effects, according to Williams' team.
Given the lack of effectiveness and potential for side effects, SSRIs cannot be recommended for children with autism, the researchers say.
For adults, Williams told Reuters Health in an email, there is "preliminary information that suggests effectiveness" for alleviating depression, anxiety, obsessive-compulsive behavior and aggression. Decisions on whether an adult with autism should try an SSRI should be made on a case-by-case basis, according to Williams.
That said, some people with autism currently on an SSRI may be doing well.
"If children or adults are on an SSRI or other antidepressant and it has improved the problem that it was prescribed for and is not causing side effects, they should continue on the medication," Williams said.
Larger, well-conducted trials of SSRIs in the treatment of autism are still needed, according to Williams. That includes studies of other SSRIs that have yet to be put to the test in clinical trials but are being prescribed to people with autism -- such as sertraline and paroxetine (Paxil).
Larger studies, Williams and her colleagues point out, might allow researchers to find out whether certain subgroups of people with autism respond better to SSRIs than others.
SOURCE: http://link.reuters.com/kat93n Cochrane Database of Systematic Reviews, August 8, 2010.
| | Spinal fluid proteins can help diagnose Alzheimer's Tue 10th August 2010 | CHICAGO (Reuters) - Measuring certain proteins in spinal fluid can accurately diagnose Alzheimer's and predict which patients with memory problems will develop the fatal brain-wasting disease, Belgian researchers said on Monday.
And they may also help identify early signs of the disease in healthy people, the team reported in the Archives of Neurology.
"The unexpected presence of the Alzheimer's disease signature in more than one-third of cognitively normal subjects suggests that Alzheimer's disease pathology is active and detectable earlier than has heretofore been envisioned," Geert De Meyer of Ghent University in Belgium and colleagues wrote.
They said measuring traces of beta amyloid and tau -- two proteins associated with the telltale plaques and tangles that form in the brains of patients with Alzheimer's -- accurately detected Alzheimer's in 90 percent of patients with the disease.
They were also able to detect 100 percent of people with memory impairments who would progress to Alzheimer's disease within five years. And they detected Alzheimer's proteins in 36 percent of people with normal brain function.
The study is the latest to show that measuring disease-related proteins in spinal fluid is useful in diagnosing Alzheimer's disease.
Currently, only an autopsy can confirm that a person has Alzheimer's, a fatal and incurable deterioration of the brain that affects more than 26 million people globally.
Doctors diagnose Alzheimer's by excluding other causes of memory loss, such as stroke, tumors and heavy drinking. They can also administer simple paper-and-pencil tests.
But biomarkers -- proteins and imaging techniques -- are helping to identify the disease much earlier.
Last month, experts at the National Institute on Aging and the Alzheimer's Association proposed new guidelines for diagnosing Alzheimer's even before patients have symptoms. [ID:nN13273900] These proposed rules included measurements of cerebral-spinal fluid.
In the study, De Meyer and colleagues analyzed spinal fluid from 114 adults with normal brain function, 200 who had mild cognitive impairment -- a precursor to dementia -- and 102 who had Alzheimer's. They identified one protein signature that was associated with Alzheimer's, and another that indicated healthy brain function.
When they looked to see how accurate these signatures were at spotting the disease, they found 90 percent of those with Alzheimer's had the disease pattern in their spinal fluid. The pattern was present in 72 percent of those with mild cognitive impairment and 36 percent of those who were normal.
Source: Reuters | | Women Risk Children's Health by Eating Licorice in Pregnancy Tue 10th August 2010 | The sweet taste of licorice may be tempting, but expecting mothers should steer clear because it may increase their child's risk of disease later in life, London's Daily Mail reported.
Children exposed to licorice in the womb were found to have up to one-third higher levels of cortisol, a hormone linked to diabetes, high blood pressure and obesity, than those who weren't.
Experts from London's Great Ormond Street Hospital and the University of Helsinki asked mothers how much licorice they ate during pregnancy and tested their children at the age of eight for cortisol levels.
The mothers of those with higher cortisol levels ate half a gram of licorice a week or more in pregnancy, one-third higher than those who didn't eat any.
The study authors believe that glycyrrhizin, a naturally occurring, sweet ingredient in licorice, affects how hormone levels are regulated.
"For those who eat a lot of licorice, it may be a good idea to cut down when pregnant," said Alexander Jones, a clinical scientist at Great Ormond Street Hospital.
Twizzlers Black Licorice, a popular product for the Hershey Candy Corporation, issues a warning about glycyrrhizic acid on it's website, stating:
"In excessive amounts, glycyrrhizic acid has been associated with undesirable side-effects including headache, sodium and water retention, loss of potassium, high blood pressure, and heart irregularities."
Source: Fox News
| | Gene link to meningitis infection Mon 9th August 2010 | A set of genes which renders people more prone to meningitis has been pinpointed by researchers.
The international team compared DNA from 1,400 people with bacterial meningitis and 6,000 healthy individuals, Nature Genetics reports.
They found differences in a family of genes involved in the immune response seem to make people more or less susceptible to the infection.
It is hoped the findings will lead to the development of new vaccines.
The researchers were looking at meningitis caused by the Neisseria meningitidis bacterium, which leads to swelling of the lining of the brain and blood poisoning.
It is not the first time researchers have attempted to find out if some people are more likely to catch meningitis because of their genetic make-up.
But results have previously been unclear, probably because of the small number of people studied.
In the latest study, researchers first scanned the whole genetic code of 475 British patients with meningococcal disease and 4,700 healthy individuals.
They found a clear difference in a small set of genes known to be involved in the immune system response.
When they looked again in two other European populations they found the same result.
Vaccine
The genetic differences found means that, in some people, the bacteria is able to evade the immune system and cause infection, while other people' immune systems are better equipped to fight it off.
The genes encode for a protein called factor H, and factor H related proteins.
Where there are flaws, the meningococcal bacteria is able to bind to these proteins to prevent the immune system from recognising it - almost like a Trojan horse - enabling it to get a foothold.
Study author Professor Michael Levin, an expert in international child health at Imperial College London, said the findings would be particularly useful in developing a vaccine against meningitis B, which is now responsible for most cases in the UK.
There is already an effective vaccine against meningitis C.
"It seems that the genetic differences in factor H between people is what determines susceptibility or resistance.
"It suggests it may be an important protein to include in vaccines, and factor H is already one of the candidates for meningitis B vaccine."
He said the results will also help scientists better tailor vaccines to be effective in the whole population.
It may also open up avenues for improving treatment once people have bacterial meningitis, he said.
Sue Davie, chief executive of the Meningitis Trust, said: "This exciting work has thrown new light on factors that play a part in determining why some people get meningococcal disease and others do not.
"Further work will be needed to establish just what the genetic differences are in the genes which actually cause this susceptibility to invasive infection, but this is a promising start."
Source: BBC
| | Spinal cord regeneration success in mice Mon 9th August 2010 | US researchers have for the first time encouraged substantial regrowth in nerves controlling voluntary movement after spinal cord injury.
By manipulating an enzyme involved in cell growth, researchers were able to regenerate spinal cord nerves in mice, Nature Neuroscience reports.
It follows similar work on repairing the optic nerve to restore sight.
UK experts said the next challenge would be to turn the findings into a treatment suitable for humans.
The ability to grow new nerve cells is present at birth but then diminishes with age.
It means that after injury or illness to the spine such cells, known as axons, cannot regenerate.
In the latest study the researchers attempted to switch back on the signalling pathway that encourages this new growth in young mammals.
They did it by knocking out a gene called PTEN in mice which in normal circumstances puts a halt on new nerve growth.
The team, from Harvard Medical School and the University of California, Irvine, reported substantial regrowth in severed spinal cords in the animals.
They are now working on tests to see if the technique can actually restore spinal cord function.
Potential treatment
Study author Professor Oswald Steward said: "Until now, such robust nerve regeneration has been impossible in the spinal cord.
"Paralysis and loss of function from spinal cord injury has been considered untreatable, but our discovery points the way toward a potential therapy to induce regeneration of nerve connections following spinal cord injury in people."
Professor James Fawcett, head of clinical neuroscience at Cambridge University, said there was an awful lot of work going on in this area and the results were exciting.
But he pointed out: "It seems to work in young mice but we need to see what happens in older mice.
"We need to make it clear that this is not ready for human patients."
Dr Michael Coleman, from The Babraham Institute in Cambridge added that the challenge would be taking the results and turning them into a treatment that could be used in humans.
"Finding drugs to block the same pathway would be one approach as even gene therapy, which is highly experimental, could not easily 'remove' a gene as they have done so here."
Source: BBC
| | Don't Let Germy Gyms Get You Sick Mon 9th August 2010 | From yoga mats to exercise machines and in many other spots, gyms can be a breeding ground for germs. A recent paper on skin diseases published by the National Athletic Trainers' Association says it's imperative that you wipe down those machines and mats if you want to guard against infection. The report covers everything from the towels to use and when to shower. On "The Early Show on Saturday Morning," Dr. Kavita Mariwala discussed those tips and other ways you can try to keep from getting more than you bargain for during your workout.
TOP THREE PLACES AT YOUR LOCAL "Y" OR GYM THAT ARE THE GERMIEST:
They are the shower, mats, and exercise machines, especially things that have handles. For example, in the shower you can catch athlete's foot if you don't wear shower shoes. On the yoga mats, you can get Folliculitis.
That's from when people sweat on the mat right before you. If you don't wipe it down, bacteria form their pores can get transmitted to you once you make contact with the mat. That can infect your skin and it can show up in the form of pimples, a blanket of pimples.
For the exercise machines, there are usually a lot of resident bacteria. If you have any open cuts or abrasions, you want to make sure you keep them covered. You don't catch one specific thing from the machines, but studies show that this is the germiest place in the gym. A lot of times, you're sweating and you're using towels on the machines and those towels can carry fungal bacteria, such as ringworm.
SKIN INFECTIONS
Athletes Foot is very easy to get. It's a fungal infection you catch on your feet, but it's very easy to spread to other parts of your body. It's itchy and uncomfortable. To get rid of it, use a topical agent, but if it gets really bad, you have to take a pill, an oral anti-fungal. The best way to avoid it is to use shower shoes and to dry off well between your toes.
Folliculitis is something you can catch from sharing sweaty mats and not showering directly after the gym. It looks like back acne or chest acne. A dermatologist will prescribe a few washes and you use that until it clears up.
MRSA 's prevalence of it is increasing in the community. If you notice a boil or pimples on exposed skin - arms, legs, back - and it's getting red and growing rapidly, you want to have it checked out immediately. It can be quite serious if not taken care of promptly.
STEPS YOU CAN TAKE
The best thing you can do is wash your hands frequently. Do thay at the gym and in your everyday life. It doesn't have to be with soap and water. You can use antibacterial lotion or gel. But make sure you rub your hands together for 15 seconds and make sure you let it air dry or use paper towels, but don't use a towel if the gym has it there because that will increase your chances of getting ringworm.
Make sure you wash your hands every time after you work out. Before you grab any mat, take a quick look at it and wipe it down with anti-bacterial wipes, especially the part you expect to be lying on, and let it dry. Some people use towels, but ask how the gyms wash them - do they bleach them? If they use colored towels, they're probably not using bleach.
You want to make sure those towels are clean and that they use bleach. You could also use anti-microbial soap. I suggest Hibiclens or Dial soap. You can buy the travel size of Hibiclens at any local pharmacy. It's best to go with anti-microbial instead of antibacterial soaps, because you're hitting all classes of germs: fungal, bacterial, and viral.
Lastly use two gym bags, one for your dirty clothes and one for your clean clothes. That separates what's dirty and what's clean, so germs don't sit and incubate or spread. Use machine-washable bags and wash them after every two ot three trips to the gym.
TIPS TO GUARD AGAINST INFECTION:
De-Germ at the Gym Cover cuts with waterproof dressing before swimming; chlorine doesn't kill everything.
Run water fountain for 15 seconds before drinking; make sure it runs clear, because you don't know how close the person was to it before you.
Bring your own bathing essentials, including a towel, razors and shower shoes.
Wipe down all equipment with anti-bacterial wipes; this includes not just the handles, but the buttons to ... anything you're touching.
Shower immediately after you work out; that's the fastest way to get bacteria off your skin. Don't wait until you get home.
Source: CBS News
| | Don't delay pregnancy after miscarriage: study Sat 7th August 2010 | NEW YORK (Reuters Health) - You don't need to delay a second pregnancy if you've had a miscarriage, Scottish researchers said Friday.
In fact, women who got pregnant within six months of their miscarriage were more likely to go on to have a live birth than those who waited longer, the researchers' report shows.
"Women are often advised to delay the second pregnancy," Dr. Sohinee Bhattacharya, who worked on the study, told Reuters Health.
Since 2005, the World Health Organization (WHO) has recommended that women wait at least half a year before they try again. According to Bhattacharya, of Aberdeen Maternity Hospital, those guidelines are widely used, but based on very little evidence.
"The sound advice to women is that there is no physical reason why you would delay your second pregnancy," she said.
In developed countries, many women have their first child later in life, which ups the chances of miscarrying. Almost a third of 40-year-olds miscarry, for example, according to the researchers, whose findings are published in the journal BMJ.
So Bhattacharya's advice is to try again as soon as possible.
"But," she added, "there is no point in saying 'Yes, go for it now' if the woman is completely drained emotionally or physically."
Other doctors say it's too early to change current practice.
"We would need some additional data to really firmly direct patients," obstetrician Dr. Alison G. Cahill of Washington University in St. Louis told Reuters Health.
"What I tell my patients is that there is some available data and that from that data the recommendation from the WHO is to wait 6 months," she said. "But when we take a step back, most women go on to have a successful pregnancy."
The Scottish researchers examined hospital data for more than 30,000 women who had a miscarriage in their first recorded pregnancy.
Of those who got pregnant within six months of the miscarriage, 85 percent gave birth to a live baby and 10 percent miscarried again.
If more time went by, however, fewer than 80 percent of the women had live births and more than 12 percent miscarried.
Those findings held even after accounting for the women's age and socioeconomic status, although adjusting for smoking tended to reduce the differences.
Bhattacharya stressed the results might not hold in developing countries, where women tend to be much younger when they have kids.
What makes the data difficult to interpret, said Cahill, is that there is no way of telling exactly how soon after their miscarriages women started trying to get pregnant again. The researchers only know when they became pregnant.
The results also say nothing about the effects of the 2005 WHO guidelines because the hospital records examined were from 1981 to 2000.
If most of the women were trying to get pregnant again right away, those who succeeded early on might have had a healthier reproductive system. That, in turn, might boost their chances of having a live birth.
Whatever the explanation, said Cahill, "the most likely outcome is a successful pregnancy."
SOURCE: http://link.reuters.com/caj73n BMJ, online August 6, 2010.
| | 'Desert dust' days may worsen kids' asthma Sat 7th August 2010 | NEW YORK (Reuters Health) - Dust blown from faraway deserts may accumulate in the air to levels great enough to contribute to children's asthma attacks, a new study suggests.
It's well established that poor air quality can worsen symptoms in people with asthma or other lung disease, and children are thought to be particularly susceptible due to factors like their smaller airways and less developed immune systems.
One recent study in the Atlanta area found that on days where levels of ozone and certain traffic pollutants were highest, the rate of children's ER visits for asthma attacks also rose.
Little has been known, however, about the potential effects of a nature-made air contaminant -- desert dust.
The dust, which contains quartz and other substances and microorganisms that may cause airway inflammation, is transported globally; dust from the Sahara in Africa, for example, can be carried across the Atlantic to the Americas.
For the new study, researchers looked at the relationship between "heavy dust events" and hospital admissions for asthma among children in Toyama, Japan -- a region with a population of about 1 million people that in the spring is susceptible to receiving dust from storms in the deserts of China and Mongolia.
They found that between 2005 and 2009, the region had a total of six heavy-dust days from February through April -- when mineral-dust levels in the air were above 1 milligram per cubic meter.
During that same time frame, 620 children between the ages of 1 and 15 were hospitalized for an asthma exacerbation. In general, children's risk of being hospitalized was 88 percent higher on a heavy-dust day compared with other days, and similarly elevated during the week following a major dust event.
The findings, reported in the American Journal of Respiratory and Critical Care Medicine, do not prove that the desert dust itself caused excess asthma attacks.
But the researchers did account for levels of pollen and air pollutants like nitrogen dioxide and small particles other than mineral dust, and the link between desert dust and asthma hospitalizations remained.
Because there were only a handful of heavy-dust days during the study period, only a small number of asthma hospitalizations would be attributable to the air-quality condition, noted lead researcher Dr. Kumiko T. Kanatani, of the Kyoto University Graduate School of Medicine in Japan.
However, in parts of the world more affected by desert dust, such days may be a more important contributor to children's asthma exacerbations, Kanatani told Reuters Health by email.
For parents of children with asthma, the findings underscore the importance of keeping an eye on local air quality, according to Kanatani.
While there may be no advisories on desert dust specifically, levels of so-called particulate matter -- especially "coarse" dust particles known as PM10 -- also rise on heavy-dust days, Kanatani noted.
And levels of particulate matter are monitored and included in local air-quality indices -- which, in the U.S., are those color-coded systems used to alert the public as to whether the day's air quality is "good," "moderate," unhealthy for people with lung disease or other chronic conditions, or potentially unhealthy for all.
According to Kanatani, a hazy sky is a good initial clue that levels of particulate matter are high that day, and it may be a good idea to limit asthmatic children's time outdoors. But parents can also go online to check local PM levels, the researcher noted.
In the U.S., local news outlets generally provide daily air-quality indices; they are also available on the government Web site AIRNow, at http://www.airnow.gov.
SOURCE: http://link.reuters.com/weg73n American Journal of Respiratory and Critical Care Medicine, online July 23, 2010.
| | Tongue piercings 'can cause damage to teeth' Sat 7th August 2010 | People with tongue piercings risk developing gaps between their front teeth as a result of playing with the stud, US researchers have found.
The University of Buffalo team says that, as well as potentially requiring cosmetic work, people can develop infections and chipped teeth.
It discusses a patient in the Journal of Clinical Orthodontics who needed braces to correct the gap in her teeth.
UK experts advised people to "steer clear" of the adornment.
The researchers said that people with tongue piercings were likely to push the metal stud up against their teeth and consequently cause gaps and other problems to arise.
Sawsan Tabbaa, professor of orthodontics at the University of Buffalo, detailed the 26-year-old's case.
She had had no space between her teeth before wearing a barbell-shaped tongue stud.
However, a space had appeared between her upper front teeth over the course of the seven years she had worn it for, because the metal bar was pushed against and between the teeth.
Temptation
Professor Tabbaa said: "The barbell is never removed because the tongue is so vascular that leaving the stud out can result in healing of the opening in the tongue, so it makes perfect sense that constant pushing of the stud against the teeth - every day with no break - will move them or drive them apart.
The author concluded that tongue piercings could result in serious injuries, not just to teeth. Piercings have also been associated with haemorrhages, infections, trauma to the gums and, in the worst cases, brain abscesses.
Dr Nigel Carter, chief executive of the British Dental Health Foundation, said:
"The temptation of playing with the stud in the mouth would be very high and in time this could lead to hundreds of pounds worth of corrective treatment.
"The results of this study stress the risks.
"In order to avoid such health problems in the future, along with the spiralling costs of any related treatment, I would advise people to stay clear of tongue piercings."
Source: BBC | | Some evidence vitamin D might fight colds Fri 6th August 2010 | NEW YORK (Reuters Health) - A daily vitamin D supplement may help young men enjoy more sick-free days during cold and flu season, a small study suggests.
Vitamin D has been the subject of much research of late, with studies linking low vitamin D levels in the blood to higher risks of type 1 diabetes and severe asthma attacks in children and, in adults, heart disease, certain cancers and depression.
But whether vitamin D is the reason for the excess risks -- and whether taking supplements can curb those risks -- has yet to be shown.
The body naturally synthesizes vitamin D when the skin is exposed to sunlight. Because rates of vitamin D insufficiency rise during the winter in many parts of the world, researchers have been interested in whether the vitamin might play a role in people's susceptibility to colds, flu and other respiratory infections.
Some past research has indeed found that people with relatively lower vitamin D levels in their blood tend to have higher rates of respiratory infections than those with higher levels of the vitamin, said Dr. Ilkka Laaksi of the University of Tampere in Finland, the lead researcher on the new study.
Along with that evidence, recent lab research has shown that vitamin D may play an "important role" in the body's immune defenses against respiratory pathogens, Laaksi wrote in an email to Reuters Health.
"However," the researcher said, "there is a lack of clinical studies of the effect of vitamin D supplementation for preventing respiratory infections."
For the current study, Laaksi's team randomly assigned 164 male military recruits to take either 400 international units (IU) of vitamin D or inactive placebo pills every day for six months -- from October to March, covering the months when people's vitamin D stores typically decline and when respiratory infections typically peak.
At the end of the study, the researchers found no clear difference between the two groups in the average number of days missed from duty due to a respiratory infection -- which included bronchitis, sinus infections, pneumonia, ear infections and sore throat.
On average, men who took vitamin D missed about two days from duty because of a respiratory infection, compared with three days in the placebo group. That difference was not significant in statistical terms.
However, men in the vitamin D group were more likely to have no days missed from work due to a respiratory illness.
Overall, 51 percent remained "healthy" throughout the six-month study, versus 36 percent of the placebo group, the researchers report.
The findings, Laaksi said, offer "some evidence" of a benefit from vitamin D against respiratory infections.
Still, the extent of the benefit was not clear. While recruits in the vitamin group were more likely to have no days missed from duty, they were no less likely to report having cold-like symptoms at some point during the study period.
Moreover, recent studies on the usefulness of vitamin D for warding off respiratory ills have come to conflicting conclusions.
A study of Japanese schoolchildren published earlier this year found that those given 1,200 IU of vitamin D each day during cold and flu season were less likely to contract influenza A. Of 167 children given the supplement, 18 developed the flu, compared with 31 of 167 children given placebo pills.
On the other hand, a recent study of 162 adults found that those who took 2,000 IU of vitamin D everyday for 12 weeks were no less likely to develop respiratory infections than those given placebo pills.
Laaksi said that larger clinical trials looking at different doses of vitamin D are still needed before the vitamin can be recommended for curbing the risk of respiratory infections.
In the U.S., health officials recommend that adults up to the age of 50 get 200 IU of vitamin D each day, while older adults should get 400 to 600 IU. The upper limit is currently set at 2,000 IU per day; higher intakes may raise the risks of side effects.
Symptoms of vitamin D toxicity are often vague and include nausea, vomiting, constipation, poor appetite and weight loss. Excessive vitamin D in the blood can also raise blood pressure or trigger heart rhythm abnormalities.
Some researchers believe that people need more vitamin D than is currently recommended, and that intakes above 2,000 IU per day are safe. However, exactly what the optimal vitamin D intake might be remains under debate.
Food sources of vitamin D include milk, breakfast cereals and orange juice fortified with vitamin D, as well as some fatty fish, like salmon and mackerel. Experts generally recommend vitamin pills for people who do not get enough of the vitamin from food.
SOURCE: http://link.reuters.com/dan53n Journal of Infectious Diseases, online July 15, 2010.
| | Diabetes and literacy key to beat dementia, says study Fri 6th August 2010 | Preventing diabetes and depression could have a dramatic impact on cutting cases of dementia, a study suggests.
Boosting levels of education and upping fruit and vegetable consumption would also have a big effect, the British Medical Journal said.
It comes as another study showed dementia patients are missing out on vital early treatments because GPs are being slow to diagnose them.
It is estimated that one million people in the UK will have dementia by 2025.
Several risk factors for the disease have been identified, including obesity, high blood pressure and high cholesterol.
But British and French researchers wanted to assess what public health interventions could have the biggest impact on reducing the burden of dementia in the population.
They took a group of 1,400 elderly people and tested them for signs of dementia after two, four and seven years.
Alongside this they recorded height, weight, education level, monthly income, mobility, dietary habits, alcohol consumption, and tobacco use and asked participants to do a reading test as a measure of intelligence.
Eliminating depression and diabetes and increasing fruit and vegetable consumption were estimated to lead to an overall 21% reduction in new cases of dementia
Increasing education would also lead to an estimated 18% reduction in new cases of dementia across the general population over the next seven years, they reported.
By contrast, removing a gene linked with the disease would only cut new cases by 7%.
Literacy
The team concluded that early screening for diabetes and treatment of depression would be the most useful approach for trying to reduce the future burden of dementia.
And they added that encouraging literacy at all ages and trying to increase population intake of fruit and vegetables would also have an important effect but admitted that these aims were harder to achieve.
Further studies including younger adults are needed to test the impact of such approaches, they added.
In the second study also in the BMJ, analysis of health records of over 135,000 people in the UK found that people with dementia were three times more likely to die in the first year after diagnosis than those without the condition.
That suggests that diagnoses are being made in the later stages of the disease.
Study leader Dr Greta Rait from the Medical Research Council said: "GPs are going to be dealing with more and more dementia cases in future and primary care must get better at detection."
Rebecca Wood, chief executive of the Alzheimer's Research Trust, said the links between depression, diabetes and dementia were well known.
"Any policy that urges clear diagnosis and monitoring of these conditions could help make an impact on dementia.
"What is painfully evident from the study is the gaping hole that remains in our understanding and ability to diagnose or treat dementia effectively, a hole that can only be filled by more research."
Professor Clive Ballard, director of research at the Alzheimer's Society said a healthy lifestyle is key.
"Effective prevention of diabetes, depression and heart disease could potentially improve the lives of millions of people affected by this cruel condition and reduce the billions spent on dementia care each year."
Source: BBC | | Fertility treatments eventually show 'diminishing returns' Thu 5th August 2010 | NEW YORK (Reuters Health) - Couples' chances of becoming pregnant with various forms of fertility treatment may start to fall after two or three tries with the same tactic, a new study suggests.
The findings, reported in the journal Fertility and Sterility, may offer some guidance on a question under debate in the infertility treatment field: How many treatment cycles should a couple undergo before proceeding to another -- often more intensive and expensive -- form of treatment?
There are a number of options for treating fertility problems, depending on what the cause is, if that can be determined at all.
For women who have problems with ovulation, fertility drugs may be used to stimulate the ovaries to produce and release eggs. Another option is intrauterine insemination (IUI), where sperm are placed directly into the woman's uterus via a catheter; the treatment, often used in conjunction with fertility drugs, may be used in cases where the man has certain fertility problems (like a low sperm count) or the cause of a couple's infertility is unknown.
In-vitro fertilization, or IVF, is a higher-tech procedure where a woman's eggs are fertilized in a lab dish, and the resulting embryos are implanted in her uterus several days later.
In the new study, researchers at the University of California-San Francisco (UCSF) looked at the rates of success with these three treatments among 408 couples seen at one of eight infertility centers.
Of the couples, 21 percent did not undergo any of the three treatments, though some had other procedures that are not considered "cycle-based," such as surgery to remove uterine fibroids (benign growths in and around the walls of the uterus). The group's rate of pregnancy over 18 months was 28 percent.
In comparison, couples who had one to two cycles of treatment with fertility drugs alone had a pregnancy rate of 85 percent. Those who underwent IUI had a pregnancy rate of 71 percent after one round of treatment, and 59 percent of those undergoing IVF became pregnant after one cycle.
However, the advantage of each of the three treatments declined after a certain number of attempts.
The six couples who had three or more rounds of fertility drugs alone had a pregnancy rate of 29 percent. Similarly, the advantage of IUI over no cycle-based treatment disappeared after the third attempt.
The advantage of IVF was no longer seen after the second try. Of the 52 couples who made three or more attempts, 35 percent became pregnant.
Based on these findings, and those from past studies, it seems clear that individual treatments have "diminishing success" over time, lead researcher Dr. James F. Smith, an assistant professor of urology at UCSF, told Reuters Health in an email.
"Medications only, IUI and IVF are all effective treatment choices, but their benefits don't continue indefinitely," he explained. "If couples are not getting pregnant after several cycles of each, a change to a different strategy is probably warranted."
There are a number of factors to consider in choosing a fertility treatment, including the intensity and cost. Smith pointed out that IVF is much more involved than either drugs or IUI, and includes many more clinic visits, daily medication injections and more discomfort.
Accordingly, the costs are far greater. In this study group, for example, the average cost of medication-only cycles over 18 months was about $1,200. That, Smith said, compared with $3,600 to $8,600 for 18 months of IUI, and $24,000 total for IVF.
In the U.S., the average cost for one cycle of IVF is $12,400, according to the American Society for Reproductive Medicine. Insurance coverage varies, depending on the plan and where one lives, as states have different laws regarding coverage of infertility treatment.
But for couples, the greater intensity and cost of treatment has to be balanced against the decreasing likelihood of success, and the emotional toll, of continuing with a less-intensive tactic that has so far not worked.
Smith said that in general, the per-cycle success rate is higher with IVF than with IUI.
Couples who do not become pregnant after a couple cycles of IVF still have some options. Smith said they might consider using donor eggs or sperm (the IVF group in this study did not use donors). Changes to a couple's particular IVF "protocol" might also be an option.
SOURCE: http://link.reuters.com/cyw33n Fertility and Sterility, online July 26, 2010.
| | Brain's reward system helps drive placebo effect Thu 5th August 2010 | NEW YORK (Reuters Health) - Want to maximize the placebo effect? A good way to do this, according to a new study, is to tell someone they have a decent chance of getting the real treatment instead of a fake pill, but keep them guessing.
In the study, Parkinson's disease patients given a placebo after being told they had a 75 percent chance of receiving an active drug produced significant amounts of dopamine, a chemical key to the brain's reward system that is scarce in the brains of patients with this disease.
But no dopamine response occurred in patients given placebo after being told they had a 25 percent, 50 percent, or 100 percent chance of getting real treatment.
The findings show that expectations directly regulate the power of the placebo effect by kicking the brain's reward system into gear, probably not just in Parkinson's patients but in a number of different illnesses, such as chronic pain and depression, according to Dr. A. Jon Stoessl of the Pacific Parkinson's Research Center in Vancouver, British Columbia, and his colleagues.
"The greatest form of reward is really to get better, so expectation of improvement is akin to expectation of reward," Stoessl explained in an interview.
Stoessl and his colleagues first demonstrated a relationship between the placebo effect and dopamine release in Parkinson's patients nine years ago. Given dopamine's role in the reward system, he explained, "perhaps it would be important for the placebo effect in other conditions."
In the current study, the researchers used PET scans to examine whether patients' expectations of getting an active drug would be related to the amount of dopamine released in their brain after they took a placebo.
They randomly assigned 35 patients to be informed that they had a 25 percent chance, 50 percent chance, 75 percent chance, or 100 percent chance of receiving an active drug. But all were given inactive placebo.
"There was a substantial amount of dopamine released, but only when the stated probability was 75 percent," Stoessl explained. "What that means is when you're told that the outcome is certain, that there's a 100 percent chance, you don't activate reward pathways. At lower probabilities, you just don't think there's much chance, so you don't activate the reward system either."
The release of dopamine in response to placebo also was closely correlated to the amount of dopamine released in patients' brains when they were given active medication, meaning that the placebo effect would likely add on to the real drug effect.
Parkinson's patients' reward pathways are abnormal given their loss of dopamine, Stoessl said, so results might be different in patients with normally functioning reward systems; for example, they might release dopamine when told they had a 50 percent likelihood of being given an active treatment.
Researchers could use the new findings in designing future studies, in order to minimize the placebo effect and better gauge the effect of a real drug, according to Stoessl.
Stoessl and his colleagues used something called "authorized deception" in the study, meaning that they told participants beforehand that the experiment would involve deception, without going into specifics. Directly after the test, they gave study participants the details on how they were deceived.
While deception has long been used in neuroscience and psychology research -- it can be tough to do research on the placebo effect without misleading patients -- most of the time, study participants are left in the dark, notes Dr. Franklin G. Miller, a bioethicist at the National Institutes of Health in Bethesda, Maryland. This flies in the face of informed consent, the principle that people should be told exactly what a study will entail and why it's being done so they can choose whether or not to participate in an informed way.
According to Miller, who helped develop the concept of authorized deception, Stoessl and his team were on solid ethical ground. "This approach, by alerting subjects to the use of deception, gives everyone a fair opportunity to decide whether or not they want to participate in research that has deception as part of its design," he said.
And the findings also show, he added, that health care providers can take advantage of the placebo effect while treating their patients, without having to lie to them.
"Normally your response to a drug is a product of the drug itself and the context in which it is given," Miller said, adding that this context is, basically, what the placebo effect is all about. Health care providers can harness the placebo effect for their patients' benefit, he said, by "promoting positive expectations and good doctor-patient relationships."
SOURCE: http://link.reuters.com/cab43n Archives of General Psychiatry, August 2010.
| | Does chickenpox protect against skin condition? Thu 5th August 2010 | NEW YORK (Reuters Health) - Kids who get chickenpox may be less likely to develop atopic dermatitis and asthma when they're older than their peers who don't get chickenpox - including those that are vaccinated against it, suggests a new study.
But vaccine experts warn that the study was limited, and that one finding shouldn't challenge the benefits of the chickenpox vaccine.
"There's been a very visible health benefit in terms of use of the vaccine," Dr. Jane Seward, an expert on viruses at the Centers for Disease Control and Prevention (CDC), told Reuters Health. "We're seeing very, very significant declines in deaths and hospitalizations" from chickenpox, she said. "A single study with a single finding is interesting, but it needs ... more evidence."
Atopic dermatitis is a type of eczema, often causing itchy rashes, that arises from an allergic reaction. It may also be the "first step" in a series of allergies that leads to asthma, said the study's lead author, Dr. Jonathan Silverberg, from the State University of New York Downstate Medical Center in Brooklyn.
Previous research by Silverberg and his colleagues on the body's response to chickenpox and shingles, a related skin condition, suggested that getting chickenpox could decrease a child's risk of later developing atopic dermatitis. To test this hypothesis, they examined the medical records of almost 700 children and adolescents, some with atopic dermatitis and some without the bothersome skin condition.
For each subject, the authors looked back in the records to see if they had ever been infected with chickenpox.
Kids who had chickenpox -- especially those who had it when they were young - were significantly less likely to get atopic dermatitis later, according to the results, which are published in the Journal of Allergy and Clinical Immunology. Among kids who eventually were diagnosed with atopic dermatitis, 20 percent had previously gotten chickenpox, compared with 28 percent of kids without atopic dermatitis.
The link went away for kids who had chickenpox when they were older than 10 - they were just as likely to get atopic dermatitis as other older kids who never had chickenpox.
Kids who had chickenpox were also less likely to be diagnosed with asthma after getting the virus.
Being vaccinated against chickenpox did not seem to give kids any protection against atopic dermatitis or asthma.
While "cost-effective" studies have shown that it makes economic sense to vaccinate kids against chickenpox, those studies haven't factored in the possibility that preventing kids from getting chickenpox might mean more will end up with atopic dermatitis or asthma, the authors say.
They argue that if further research confirms their findings, waiting to vaccinate kids against chickenpox until they are older (8 or 10 years old) could make the vaccine more cost-effective and prevent some cases of atopic dermatitis and asthma.
According to the CDC, the chickenpox vaccine costs about $70 to $80 per dose.
Kids are currently vaccinated at age 1, Seward said, and there's a good reason for that - because most kids who get chickenpox get it when they're very young, she said. Kids in this study who got chickenpox were an average of 3 years old when they were infected.
While chickenpox is often not viewed as very serious, Seward said, some kids do end up with pneumonia or other serious infections, and some lose limbs.
"Upfront you don't know, is this going to be a case of itchiness and fever for a couple days, or is this very serious?" she said.
Dr. Eugene Shapiro, an expert on the vaccine and a professor at Yale University School of Medicine in New Haven, Connecticut, said that before the vaccine was introduced, 12,000 people were hospitalized every year for chickenpox and 120 died.
Silverberg agreed that pushing back the age kids are vaccinated could mean more deaths from chickenpox. Allowing for increased chickenpox infections in childhood could decrease "herd immunity" -- where the level of immunity in the whole population is high enough to prevent large outbreaks of an infection - "and may place some adults at risk for getting the disease," Silverberg told Reuters Health in an email.
Still, he said, more chickenpox might mean less asthma - another potentially fatal condition.
Dr. David Kimberlin, who studies pediatrics and infectious diseases at the University of Alabama at Birmingham, cautioned about taking too much away from a study that looked back at medical records, rather than one that started with a group of kids and followed them for a number of years.
Seward noted that the study didn't take into account other factors known to affect atopic dermatitis, such as family history and other allergies - something that's hard to do with a study set up in this way, she said.
Silverberg said that looking back at records was useful because it would be hard to find lots of kids with chickenpox now, given the vaccination program.
He also said that more research - possibly including studies at the state or national level - is needed before he would recommend any changes in vaccination policy. Those studies would need to look broadly at the link between chickenpox infection and atopic dermatitis and include the costs of atopic dermatitis and asthma in the analysis of the vaccine's cost-effectiveness, he said.
SOURCE: http://link.reuters.com/taw33n Journal of Allergy and Clinical Immunology; online July 12, 2010.
| | High cholesterol dangerous in young adults, too Wed 4th August 2010 | WASHINGTON (Reuters) - Adults as young as 20 need pay attention to their cholesterol because unhealthy levels may already be damaging their arteries, researchers reported on Tuesday.
They followed a group of 18- to 30-year-olds for 20 years and found that higher cholesterol at a relatively early age increased the risk of heart disease and stroke later.
"We don't usually worry too much about heart disease risk until a person is in middle age because it's rare to have a heart attack in young adulthood," said Dr. Mark Pletcher of the University of California, San Francisco, who led the study published in the Annals of Internal Medicine.
"Young adulthood also matters. The damage you sustain then to your coronary arteries probably is going to catch up with you later," he added.
Pletcher and colleagues looked at data from more than 3,200 young adults -- roughly evenly divided between black and white, male and females. Those with high levels of low density lipoprotein -- LDL or "bad" cholesterol -- in youth were more likely to develop heart disease later, regardless of their cholesterol levels later in life.
The researchers said the results do not mean young adults necessarily need to take medicine to lower their cholesterol, but should make sure they exercise and watch what they eat.
"Diet and exercise may be more important than cholesterol-lowering medication in young adults," said Pletcher. "We don't have enough direct data in terms of effectiveness and safety of treatment of young adults to recommend that."
In an earlier study also published in the Annals of Internal Medicine, Pletcher found high blood pressure in young adults leads to higher risk of coronary heart disease later in life.
The American Heart Association recommends that everyone age 20 and older test their cholesterol once every five years. People with a reading of 200 milligrams of cholesterol per deciliter of blood are at risk for heart disease.
An estimated 17.6 million Americans have coronary heart disease, according to the American Heart Association. Heart disease is the leading cause of death in the United States and other industrialized countries.
Under federal healthcare legislation passed in March, health insurance plans must pay for preventive services, including cholesterol screening, although many do already. Most insurance holders will see this benefit starting in 2011, but large employer plans may not have to change under the new law.
The new regulations also allow young adults to stay on their parents' plans until they turn 26.
Source: Reuters
| | Experts roll out malaria map, urge mosquito study Wed 4th August 2010 | HONG KONG (Reuters) - Nearly 3 billion people, or two-fifths of the world's population, were at risk of contracting malaria in 2009 and closer study of the mosquito's life cycle is needed to combat the disease, researchers said in two reports.
In the first study, scientists mapped out the geographical spread of the Plasmodium vivax -- the most common parasite that causes malaria -- using reported cases of malaria and details on temperature and aridity.
"We estimate that the global population at risk of P. vivax malaria in 2009 was 2.85 billion people. Regionally, the great majority of this population (91 percent) resides in central and southeast Asian countries," wrote Simon Hay, a zoologist at the University of Oxford who co-authored the study.
"P. vivax remains the most widely distributed human malaria parasite even after a century of development and control," he wrote, replying to questions from Reuters.
However, chances of infection by this parasite is low across Africa because of a genetic trait that protects mostly people of African origin.
But transmission of the parasite does occur in the continent and remains a concern for travelers and people who do not carry the trait, the researchers said.
The malaria atlas was published on Wednesday in the journal PLoS Neglected Tropical Diseases.
In 2008, there were 247 million cases of malaria worldwide and nearly one million deaths, mostly among children.
Knowing where the P. vivax thrives is critical so that plans can be made to control it, wrote Carlos Guerra, another author of the atlas and also from the University of Oxford.
Hay said the parasite, which is carried by the female Anopheles mosquito, is sensitive to environmental factors.
"Low temperatures delay the development of the parasite in the mosquito and if this time exceeds the life span of the vector (mosquito), then transmission is not possible," Hay said.
"Aridity acts mainly on the vector by increasing mortality through desiccation and also by limiting the availability of suitable breeding sites (i.e. collections of water)."
In the second paper, another team of researchers said vector control measures such as insecticide-treated nets and sprays have not been able to break the transmission cycle of the Plasmodium falciparum, another parasite that causes malaria in the most endemic parts of Africa and the Pacific.
It is regarded as a more dangerous cause of malaria as it has the highest rates of complications and death.
"Global commitment to malaria eradication necessitates a corresponding long-term commitment to vector ecology," wrote Gerry Killeen from the Ifakara Health Institute in Dar es Salaam, Tanzania, and colleagues in the journal PLoS Medicine.
"Priority areas will include understanding aspects of the mosquito life cycle beyond the blood feeding processes which directly mediate malaria transmission.
Source: Reuters
| | U.S. dietary supplements often contaminated: report Wed 4th August 2010 | WASHINGTON (Reuters) - Many popular dietary supplements contain ingredients that may cause cancer, heart problems, liver or kidney damage, but U.S. stores sell them anyway and Americans spend millions on them, according to Consumer Reports.
The consumer magazine published a report on Tuesday highlighting the U.S. Food and Drug Administration's lack of power to regulate such supplements, and said the agency rarely uses what little power it does have.
The report from the influential group urged Congress to speed up small moves toward giving the agency more clout, especially in regulating supplements.
Despite the "natural" labels carried by many of the supplements, many are contaminated.
Yet Americans flock to take them, according to the magazine, citing the Nutrition Business Journal as saying the market was worth $26.7 billion in 2009.
"Of the more than 54,000 dietary supplement products in the Natural Medicines Comprehensive Database, only about a third have some level of safety and effectiveness that is supported by scientific evidence," the report reads.
In addition, the FDA has not inspected any supplement factories in China, even though the agency set up field offices there starting in 2008, Consumer Reports said.
The organization pointed to 12 supplement ingredients in particular that it said could be dangerous: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe.
Potential dangers include liver and kidney damage, heart rhythm disorders and unhealthy blood pressure levels, it said.
INDUSTRY FRIENDLY LAWS
The group is critical of the 1994 Dietary Supplement Health and Education Act or DSHEA, which it describes as industry friendly and which prevents the FDA from regulating supplements in the same way as it regulates prescription medications.
The Federal Trade Commission regulates the marketing of herbal supplements, whose makers are not allowed to claim they treat medical conditions.
The FDA has banned only one supplement ingredient -- ephedrine alkaloids -- although it has persuaded many companies to pull their products off the market.
"Supplements are marketed with very seductive and sometimes overblown sales pitches for increasing your performance in the bedroom, slimming down, or boosting your athletic prowess," said Nancy Metcalf, senior program editor for the magazine.
"And consumers are easily lulled into believing that supplements can do no harm because they're 'natural'," Metcalf said in a statement.
"However, some natural ingredients can be hazardous, and on top of that the FDA has repeatedly found hazardous ingredients, including synthetic prescription drugs, in supplements."
In May, the Government Accountability Office found that sellers of ginseng, Echinacea and other herbal and dietary supplements often tell consumers the pills can cure cancer or replace prescription medications.
Experts at the Institute of Medicine said earlier this year the FDA needs to use the same strict standards to regulate supplements as it uses for drugs, and the GAO said the FDA should ask Congress for more power to regulate supplements.
Source: Reuters | | Study: Could gut germs underlie Western allergies? Tue 3rd August 2010 | WASHINGTON (Reuters) - Germs living in the gut may cause higher rates of allergies, chronic stomach upsets and even obesity among children living in rich industrialized countries, researchers reported on Monday.
They compared intestinal bacteria between European Union children and young villagers in remote Burkina Faso, and found enough differences to help explain disparities in chronic disease and obesity.
The findings, published in the Proceedings of the National Academy of Sciences, may support the development of probiotic products to help restore the ancient balance and keep humans leaner and healthier, the researchers said.
"Our results suggest that diet has a dominant role over other possible variables such as ethnicity, sanitation, hygiene, geography, and climate, in shaping the gut microbiota," Paolo Lionetti of the University of Florence in Italy and colleagues wrote.
"We can hypothesize that the reduction in richness we observe in EU compared with Burkina Faso children, could indicate how the consumption of sugar, animal fat, and calorie-dense foods in industrialized countries is rapidly limiting the adaptive potential of the microbiota."
The study builds on a body of evidence that human health relies heavily on the trillions of microorganisms living in and on our bodies. Only a fraction cause disease directly -- many more help digest food, affect other bacteria and may influence hundreds of biological functions.
Several recent studies have found that certain bacteria cause inflammation that can affect appetite as well as inflammatory bowel conditions like Crohn's disease and colitis, including a study published in Science in March.
TRADING ONE DISEASE FOR ANOTHER
"Western developed countries successfully controlled infectious diseases during the second half of the last century, by improving sanitation and using antibiotics and vaccines," the researchers wrote.
"At the same time, a rise in new diseases such as allergic, autoimmune disorders, and inflammatory bowel disease both in adults and in children has been observed," they added
Lionetti's team studied the DNA of the gut bacteria of children in Burkina Faso, who are breast-fed up to age two and eat a diet likely similar to stone-age humans, rich in whole grains such as millet, legumes such as black-eyed peas, and vegetables. They eat very little meat.
The Western diet, in contrast, is heavy in meat, processed grains, sugar and fat.
The Italian team found the African children had many bacteria that help break down fiber, but the European children were lacking these microbes. The ratios were similar to studies comparing the gut bacteria of lean people to obese people.
This bacterial balance could even be causing obesity, the researchers said. It may also be useful to test children for these bacteria to see if they are at high risk of becoming obese, they said.
"Reduction in microbial richness is possibly one of the undesirable effects of globalization and of eating generic, nutrient-rich, uncontaminated foods," Lionetti's team wrote in the study, available at http://www.pnas.org/cgi/doi/10.1073/pnas.1005963107.
| | Low-carb edges low-fat for heart risk factors Tue 3rd August 2010 | NEW YORK (Reuters Health) - Low-fat and low-carbohydrate diets can be equally effective at helping obese adults shed weight over the longer term, but cutting carbs may have an advantage when it comes to some heart risk factors, a study published Monday suggests.
Researchers say the findings offer reassurance that low-carb diets -- which tend to be relatively high in fat -- are not a threat to heart health.
Instead, the study found that over two years, people on the low-carb plan had a greater increase in "good" HDL cholesterol than those on the low-fat regimen. They also had a more significant dip in diastolic blood pressure, the bottom number in a blood pressure reading.
Still, that does not mean that everyone hoping to lose weight should go low-carb, according to lead researcher Dr. Gary D. Foster of Temple University in Philadelphia.
Both diets, he told Reuters Health in an interview, helped people shed pounds and improve their risk factors for heart disease. So the bottom line is that individuals should choose the diet changes that they can live with for the long haul, according to Foster.
"With either diet, you're looking pretty good," he said.
The caveat, though, is that everyone in the study adopted their diets as part of an overall program focused on lifestyle change.
They were instructed to start exercising regularly -- mostly brisk walking -- and learned tactics for weight management, such as writing down what they ate every day and setting reasonable short-term goals (if you normally eat 10 candy bars a week, for instance, first try cutting out a couple rather than going cold-turkey.)
And that behavioral shift may be key in helping people keep the weight off in the long run. Foster cautioned against "becoming myopically focused on what you should or shouldn't eat."
The study findings, which appear in the Annals of Internal Medicine, are based on 307 middle-aged obese adults who were randomly assigned to either a low-fat or low-carb diet, plus the lifestyle program.
People in the low-carb group followed an Atkins-style plan, strictly limiting carbohydrates for the first 12 weeks to 20 grams, or about 80 calories' worth of carbs, per day -- with vegetables as the only source. After that phase, they gradually added small amounts of carbs from certain fruits, grains and dairy. They were allowed unlimited amounts of fat and protein.
People in the low-fat group cut their calories to between 1,200 and 1,800 per day, depending on their sex and initial body weight, and aimed to get 55 percent of their calories from carbs, 15 percent from protein and 30 percent from fat.
Over the first year, the whole study group averaged a weight loss of about 22 pounds; after the second year, they'd managed to keep off about 15 pounds, on average. There was no significant difference between the low-fat and low-carb groups, Foster's team found.
In the first six months of the study, the low-fat group had the edge when it came to "bad" LDL cholesterol. On average, their LDL fell by about 10 mg/dL, from a starting point of 124 mg/dL; LDL levels below 100 mg/dL are considered "optimal."
In the low-carb group, LDL initially rose during the first three months -- probably, according to Foster, because of participants' newfound freedom to eat unlimited fat. But by year two, both diet groups had LDL levels that were several points lower than their starting numbers, with no significant difference between the groups.
Similarly, triglycerides (another type of blood fat) and systolic blood pressure (the top number in the reading) declined to a comparable degree in both groups.
When it came to HDL, the average for the low-carb group rose by nearly 8 mg/dL, from a starting point of 46 mg/dL; HDL levels below 40 mg/dL are considered a risk factor for heart disease, and ideally, levels should be at least 60 mg/dL.
HDL levels in the low-fat group rose by almost 5 mg/dL, on average, from a starting point of 45 mg/dL.
The low-carb group also had a modest advantage when it came to diastolic blood pressure, showing a three-point decline at year two, versus a half-point dip in the low-fat group.
Some side effects were more common among low-carb eaters. At the six-month mark, 45 percent reported hair loss, versus 21 percent of the low-fat group. After three months, nearly two-thirds said they had problems with bad breath, compared with 37 percent of the low-fat group.
The only persistent side effect, however, was constipation. After two years, 39 percent of the low-carb group reported constipation, versus 17 percent of the low-fat eaters.
It's not yet clear why the low-carb diet created a greater increase in HDL cholesterol, according to Foster. But the findings suggest that increased fat intake, itself, may be responsible.
However, whether that HDL advantage actually translates into greater heart-health benefits is unclear.
For now, Foster said, the message is that either a low-fat or low-carb diet can work in the longer term. He also noted that people do not necessarily have to join a formal program to learn the behavioral changes that can help them succeed, as the same type of information is available online and in books.
SOURCE: http://link.reuters.com/kaf82n Annals of Internal Medicine, August 3, 2010.
| | Internet addicts more likely to develop depression Tue 3rd August 2010 | HONG KONG (Reuters) - Teenagers who spend excessive amounts of time on the Internet are one and a half times more likely to develop depression than moderate web users, a study in China has found.
Researcher Lawrence Lam described some of the signs of excessive use spending at least five to more than 10 hours a day on the web, agitation when the teens is not in front of the computer and loss of interest in social interaction.
"Some spend more than 10 hours a day, they are really problematic users and they show signs and symptoms of addictive behavior ... browsing the Internet, playing games," said Lam, co-author of the paper which was published on Tuesday in the Archives of Pediatrics & Adolescent Medicine.
"They can't get their minds off the Internet, they feel agitated if they don't get back on after a short period of being away," the psychologist at Sydney's University of Notre Dame's School of Medicine said in a telephone interview.
"They don't want to see friends, don't want to join family gatherings, don't want to spend time with parents or siblings."
The study involved 1,041 teenagers aged between 13 and 18 years in China's southern Guangzhou city who were free of depression at the start of the investigation.
Nine months later, 84 of them were assessed as suffering from depression and those who were on the Internet excessively were one-and-a-half times more vulnerable than moderate users.
"Results suggested that young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence," wrote Lam, who co-authored the paper with Zi-wen Peng at the Sun Yat-Sen University's School of Public Health in Guangzhou.
The depression might be a result of lack of sleep and stress from competitive online games, he explained.
"People who spend so much time on the Internet will lose sleep and it is a very well established fact that the less one sleeps, the higher the chances of depression," Lam said.
Lam said this was the first study looking into pathological use of the Internet as a possible cause for depression.
A previous study pointed to depression as a possible causal factor for Internet addiction, while several other studies showed a link between the two without clearly pointing which was the cause and which one the result.
Lam called for schools to screen students for Internet addiction, so they may receive counseling and treatment.
Source: Reuters | | Damp house linked to kids' risk of nasal allergies Mon 2nd August 2010 | NEW YORK (Reuters Health) - Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests.
Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period.
Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold.
In this study, published in the American Journal of Epidemiology, 16 percent of children whose parents reported dampness in the home went on to be diagnosed with allergic rhinitis over the next six years. That compared with just under 12 percent of children whose parents reported no dampness problems -- that is, no visible signs of water damage to the ceilings, walls or floors, and no visible mold or mold odor in the home.
The researchers weighed a number of factors that might help account for the connection, including families' socioeconomic status (asthma and allergies tend to be common in lower income children) and whether children were also exposed to second-hand smoke.
However, damp, moldy conditions in the home remained linked to an increased risk of children's nasal allergies. Children whose parents reported any mold or water damage in the home at the outset were 55 percent more likely than other children to develop allergic rhinitis -- connected to any allergen, and not just mold.
"Our study strengthens the evidence that exposure to indoor dampness increases the risk of developing allergic rhinitis," lead researcher Dr. Jouni Jaakkola, of the Institute of Health Sciences in Oulu, Finland, told Reuters Health in an email.
Previous studies, he said, had measured children's exposure to dampness and mold, and their rates of nasal allergies, all at one time -- making it impossible to tell whether the exposure preceded the allergies' development.
The fact that this study followed children's rates of allergy development over time strengthens the case that household dampness is a risk factor for nasal allergies -- though the findings alone do not prove cause-and-effect. It is still possible that there are other factors that explain the link.
However, Jaakkola said that based on other research, it is plausible that damp conditions in the house contribute to nasal allergies. Such conditions, he noted, encourage the growth of dust mites and fungi, and attract cockroaches -- all of which can serve as allergy triggers. Moisture may also boost the emission of chemicals from building materials, according to Jaakkola, and those chemicals could potentially create inflammation in the airways.
The bottom line for parents, Jaakkola said, is that they would be wise to look out for signs of water damage at home.
"In general, we should try to avoid dampness problems in homes and repair (damage) as soon as the problems appear," he noted, adding that parents of children who already have any form of allergy should be particularly careful to do so.
SOURCE: http://link.reuters.com/ker32n
American Journal of Epidemiology, online July 16, 2010.
| | Herpes virus used to treat cancer Mon 2nd August 2010 | Doctors say they have used a genetically engineered herpes virus to treat successfully patients with head and neck cancer.
A London hospital trial of 17 patients found that use of the virus alongside chemotherapy and radiotherapy helped kill the tumours in most patients.
It works by getting into cancer cells, killing them from the inside, and also boosting the patient's immune system.
Further trials are planned for later in the year.
Head and neck cancer, which includes cancer of the mouth, tongue and throat, affects up to 8,000 people every year in the UK.
Study leader Dr Kevin Harrington, who is based at the Institute of Cancer Research in London, said current treatments were effective if the cancer was picked up early but that many patients were not diagnosed until it was more advanced.
The herpes virus, which is also being tested in patients with skin cancer, is genetically manipulated so that it grows inside tumour cells but cannot infect normal healthy cells.
Once there it has a triple effect - it multiplies, killing tumour cells as it does so, it is engineered to produce a human protein that activates the immune system and it also makes a viral protein that acts as a red flag to immune cells.
'Potential weapon'
In the 17 patients injected with the virus, in addition to their standard treatment, at the Royal Marsden Hospital, 93% showed no trace of cancer after their tumour had been surgically removed.
More than two years later, 82% of patients had not succumbed to the disease.
Only two of 13 patients given the virus treatment at a high dose relapsed, the journal Clinical Cancer Research reported.
There were no safety concerns with use of the virus, the researchers said, and it is hoped the virus could one day be used to fight other types of cancer.
"Around 35 to 55% of patients given the standard chemotherapy and radiotherapy treatment typically relapse within two years, so these results compare very favourably," said Dr Harrington.
He is now planning a trial comparing the viral treatment with the standard treatment in people newly diagnosed with head and neck cancer.
Dr Alison Ross, senior science information officer at Cancer Research UK, said it would be some time before the treatment could be used in patients as it still needed to be tested directly against standard treatment.
But she added: "This small study highlights the potential of using genetically modified viruses as a weapon to fight cancer."
Source: BBC | | Traditional Chinese medicine passes to foreign "heirs" Mon 2nd August 2010 | NANJING, July 31 (Xinhua) -- In an east China traditional Chinese medicine (TCM) hospital, Briton Kate Steiner is watching a doctor take pulses, examine tongues and ask about symptoms.
Steiner, 25, has been studying TCM at Nanjing University of Chinese Medicine in Jiangsu Province for two years. She frequents the provincial TCM hospital to learn from TCM practioners during her summer break.
"I like to accompany my friends who are also overseas students to visit TCM doctors. I ask questions and take notes of prescriptions doctors give to my friends," says Steiner. She is one of 1,300 overseas students who make up more than 10 percent of the university's 12,660 students.
Overseas students graduating from prestigious TCM universities across China every year are becoming known as the foreign "heirs" of the country's thousand-year medical heritage.
Before TCM was systemized in the 1950s under the People's Republic of China, it was only practiced within inherited family systems.
At that time, TCM gurus hid in locked rooms to mix "secret formula" medications.
It took two years of language studies to enable Steiner to understand most of her classes.
She says she was inspired to study TCM by Giovanni Maciocia, an Italian practioner of acupuncture and Chinese herbal medicine.
Maciocia also trained at Nanjing University of Traditional Chinese Medicine, before practicing in London and compiling English TCM textbooks.
"I also got support from my uncle who's a Western medicine doctor. He used to cast doubt on TCM, because it cannot be explained with scientific methodology, but later he found TCM therapies did work in treating stroke sequela when he visited a TCM center in Germany," she says.
She wants to run her own TCM clinic back home after graduation, but she is one of a small number of Westerners who understand and trust TCM.
Though traditional Chinese medicine is accepted in mainstream medical care throughout East Asia, it is considered an alternative medical system -- if not quackery -- in much of the Western world.
Traditional Chinese Medicine includes a range of practices such as Chinese herbal medicine, acupuncture and massage therapy. It's based on the philosophy that the human body contains several interconnected systems which work in balance to keep the body healthy.
Professor Di Liuqing, of the Nanjing University of Chinese Medicine, says the TCM philosophy is difficult to comprehend for people from other cultures.
"According to TCM theory, health is seen as a state of balance between the yin and the yang, metaphysical terms that are hard to explain, and quite different to anatomy-based Western medical science," says Di.
As practices identical or similar to TCM exist elsewhere in East Asia, it's easier to accept for students from this region.
Panahafhi Poru, a Japanese student of Western clinical medicine at Peking University Health Science Center, took an elective class in TCM this semester.
She has faith in TCM because it has helped her own family.
"When I was young, my older brother lost his hearing in a car accident. Doctors said the deafness would be permanent," she recalls.
"My mom took him to a TCM doctor in Japan who prescribed exuviae (cast-off skins) of cicadas. My brother followed the prescription and gradually recovered his hearing, but I don't know why it worked."
Despite her faith in TCM, Poru only uses TCM to supplement Western treatments.
"I take traditional Chinese anti-viral drugs when I get a cold, but only with Western medicines. I believe TCM can alleviate sickness, but for a cure, we still have to take Western medicines in most cases," she says.
Park Jiho, a South Korean studying TCM at Shandong University of Traditional Chinese Medicine, has no problem in accepting TCM because it has much in common with traditional Korean medicine.
He is an intern in the acupuncture section of the provincial TCM hospital of Shandong during his summer break, and will begin post-graduate studies in acupuncture and massage therapy when college returns.
"As I am learning from practioners, I understand TCM needs a lot of hands-on experience," says Park. "Merely following books doesn't work.
"A patient suffering leg pains came to us the other day, and my tutor administered acupuncture at a point that was not the one textbook tells us.
"My tutor told me it came from her own observation through decades of practice, and I think that is the striking difference between Chinese and Western medicine," says Park.
"What also interests me is that TCM applies a holistic approach to treat patients. If a patients suffers a headache, the doctor won't just fix his head problem, but also associated organs."
However, Park says he cannot practice TCM at home as the government of Republic of Korea (ROK) does not recognize a college degree in TCM.
"Still, I want to introduce TCM to more South Koreans and I believe the government will liberalize regulation of TCM sooner or later."
China institutions are working with schools and institutes abroad to train more TCM "heirs."
Nanjing University of Chinese Medicine is about to receive 45 students from the Acupuncture School of Oslo (AKHS) next month. They will take internships at the university's affiliated hospital.
Zhang Xu, deputy dean of the university's overseas education school, says short term exchange programs are also scheduled next year.
Source: Xinhua News
| | For blood pressure, can you be fit but fat? Sat 31st July 2010 | NEW YORK (Reuters Health) - If you're trying to bring your blood pressure to healthy levels, a new study suggests that how much you weigh is more important than how fit you are.
As expected, the study found that overweight or obese people were more likely to have a high systolic blood pressure - the top number in a blood pressure reading. But for those with a high body mass index (BMI) - a measure of weight versus height -- how in shape they were only had a small impact on their blood pressure.
The results suggest that people who are trying to decrease their risk for high blood pressure should focus on losing weight however they can most effectively do that, the authors say, and that increasing physical fitness should be a secondary goal.
"Obesity is such a strong predictor of blood pressure or hypertension risk that having a normal body weight is really what's going to drive your blood pressure" rather than your fitness level, Dr. Susan Lakoski, a cardiologist at the University of Texas Southwestern Medical Center and one of the study's authors, told Reuters Health.
At least in terms of lowering your risk for high blood pressure, she said, "it's not realistic to be fit and fat."
One in three American adults has high blood pressure - above 140/90 - including more than half of those over 55. Having high blood pressure puts a person at greater risk for stroke, heart attack, and kidney disease.
The Centers for Disease Control and Prevention reports that high blood pressure will cost the U.S. more than $75 billion in 2010 - from hospital stays and doctors' appointments, drugs, and lost time at work. Doctors often recommend medication and lifestyle changes, including exercise, for patients with high blood pressure.
In the study, published in the American Heart Journal, Lakoski and her colleagues analyzed data from approximately 35,000 patients, mostly white men, collected over the last 20 years at the Cooper Clinic in Dallas, Texas. When patients came into the clinic, doctors measured their body composition, blood pressure, and fitness levels.
To determine how fit patients were, the doctors timed how long they could keep up a comfortable walking pace on a treadmill at varying inclines and speeds.
Using this data, the authors compared BMI, fitness levels, and systolic blood pressure of all patients to see if the three measurements were linked. Among all participants, having a higher BMI was associated with having a higher systolic blood pressure, a correlation that has been found many times in the past.
But being fit had less of an effect on systolic blood pressure readings than BMI, and when the authors looked at people of the same age and gender, fitness didn't seem to have any effect on blood pressure.
Only people of normal weight seemed to get much of a blood pressure benefit from having better fitness levels - possibly because fitness alone couldn't overcome the negative effects of being obese, Lakoski said.
That doesn't mean that people who are overweight shouldn't try to improve their fitness, said Dr. Paul McAuley, who teaches health education at Winston-Salem State University in North Carolina. McAuley pointed out that the study is only a snapshot of one group of people at one time. The study doesn't show how the participants fared over the long term.
His research has shown that people who are obese but fit aren't any more likely to die from heart disease and stroke - or any cause - than people who are thinner and fit.
"We've got to back off and say, 'what is blood pressure measuring?'" McAuley told Reuters Health. "It's an indicator just like a weatherman would use. It's not the disease itself."
Whether or not being in better shape affects a person's blood pressure, McAuley said, "fitness does something to prevent disease and mortality."
Lakoski agreed that for overall health and mortality risk, fitness is an important part of the picture. "The ultimate thing we'd like to see is people obtain a lean body weight and start improving their fitness in the real world," she said.
Dr. Tim Church, the former head of medical research at The Cooper Institute who now studies exercise and disease at Louisiana State University's Pennington Biomedical Research Center, told Reuters Health that the findings don't change the current thinking on exercise and long-term health.
"Being overweight is bad for you (and) being sedentary is bad for you," he said.
SOURCE: http://link.reuters.com/duc89m American Heart Journal, July 2010.
| | Mobile Phones 18 Times Dirtier Than Toilet Handles Sat 31st July 2010 | You may want to peel your mobile phone away from your face, considering it may be dirtier than a toilet handle, the Daily Mail reported.
A U.K. study tested 30 mobile phones for levels of potentially harmful bacteria, or the total viable bacterial count (TVC).
High TVC levels don't pose any immediate harm, but usually indicate poor hygiene.
The results revealed that 25 percent exceeded the acceptable TVC by 10 times and have 18 times the TVC as a handle on a public restroom toilet. The Which? magazine study suggests that 14.7 million of the 63 million phones being used in the U.K. could pose a health risk, the report said.
"Most phones didn't have any immediate harmful bacteria that would make you sick straight away, but they were grubbier than they could be," said Ceri Stanaway, a researcher with Which? magazine.
One phone's TVC level was so high it put its owner at risk of a serious stomach ache, the report said.
"The levels of potentially harmful bacteria on one mobile were off the scale. That phone needs sterilizing," Jim Francis, a hygiene expert, said.
The phone with the most bacteria had more than ten times the acceptable level, as well as 39 times the safe level of enterobacteria, which includes Salmonella.
"What this shows is how easy it is to come into contact with bacteria," Stanaway said. "People see toilet flushes as being something dirty to touch, but they have less bacteria than phones."
The tests also found E. coli and staphylococcus aureus, among other food poisoning bugs, but at safe levels. There was also 170 times the acceptable level of the bacteria associated with human waste, fecal coliforms.
"People need to be mindful of that by observing good hygiene themselves and among others who they pass the phone to when looking at photos, for example," Stanaway said.
Source: Fox News | | Market Watch: Fresh goji berries make their debut Sat 31st July 2010 | Goji berries, the much-hyped "superfruit" native to China, touted for their medicinal properties and surprisingly delicious too, are now available for the first time as fresh fruit at local farmers markets.
The berries, which sometimes still have their green stalks attached, are small, about the size of an average blueberry, but are elliptical or conical, often pointed at the end. They have smooth, thin, flaming red-orange skin, about the color of a ripe Hachiya persimmon; their texture ranges from firm to flabby, depending on ripeness; and their flavor varies from slightly vegetal and tomatoey, in a few underripe specimens, to rich and sweet, evoking persimmon, rose and raisin, with a spicy aftertaste. They're actually more interesting than one would think based on the dried fruits and juice of goji imported from China, which have become popular in recent years for their high antioxidant and phenolic content.
The gojis available here now are grown by Chuck Garrigus, 47, a raisin farmer in Selma whose name may be familiar because his late grandfather, Charles B. Garrigus, was the poet laureate of California from 1966 to 2000. Chuck Garrigus became interested in goji about eight years ago when his daughter, then 8 years old, was diagnosed with Type 1 diabetes and a teacher suggested that a "fruitaceutical" beverage containing goji would be good for her. Garrigus researched goji just to fend him off, but while doing so he became convinced himself of the fruit's healthful properties and began planting 4 acres of the bushy trees from seed imported from China.
The trees, which are certified organic, took their own sweet time to bear fruit, about four to six years, but half of them are now producing. Last year Garrigus shipped seven loads of his crop, packed in little plastic clamshells, to Whole Foods stores, but the delicate gojis proved quite perishable, so this year he's trying to sell directly to customers through farmers markets.
Source: Los Angeles Times | | Calcium supplements may raise risk of heart attack Fri 30th July 2010 | HONG KONG (Reuters) - Calcium supplements, which many people consume hoping to ward off osteoporosis, may increase the risk of heart attack by as much as 30 percent, researchers reported Friday.
These tiny tablets which carry concentrated doses of calcium were also associated with higher incidences of stroke and death, but they were not statistically significant.
The researchers advised people consuming calcium supplements to seek advice from their doctors, take more calcium-rich foods and try other interventions like exercise, not smoking and keeping a healthy weight to prevent osteoporosis.
"People regard calcium supplements as natural but they are really not natural at all," Ian Reid, professor of medicine at the University of Auckland in New Zealand, said in a telephone interview.
Reid and colleagues in Britain and the United States conducted a meta-analysis encompassing 11 studies that tracked nearly 12,000 elderly people over four years.
Half of them were given calcium supplements and the other half placebo or dummy pills with no therapeutic content. The results were published in the British Medical Journal.
"What we found was a 30 percent increase in heart attacks in the people who were randomized to take calcium," Reid said.
"If you have 1,000 people taking calcium for five years, we will expect to find 14 more heart attacks, 10 more strokes and 13 more deaths in the people given calcium than they would have had if they hadn't been treated with calcium," Reid said.
"That is 37 more adverse events and we expect 26 fractures being prevented. So calcium is associated with more bad things happening than with bad things prevented."
While experts are not certain about the biological mechanism by which calcium supplements may damage the body, studies in the past have linked high levels of blood calcium to more heart attacks and damage to blood vessels, Reid said.
"When you take calcium supplements, your blood calcium level goes up over the following four to six hours and goes up to the top end of the normal range," he said.
"That doesn't happen when you have calcium to eat in your diet because the calcium from food is very slowly absorbed and so the blood calcium level hardly changes at all."
Higher blood calcium may lead to the formation of plaques in blood vessels, which can lead to heart attack, stroke and other cardiovascular diseases, Reid explained.
"People have always focused on fat levels in the blood as driving that process (plaque formation) but there is increasing evidence now that calcium levels in the blood might drive that as well," he added.
Source: Reuters | | 9 natural cures you can trust Fri 30th July 2010 | Prevention
As a forward-thinking woman who embraces safe and natural health strategies for you and your family, you'll be delighted by this verdict: Scientists have compiled compelling new evidence affirming the ability of many complementary and alternative medicines (CAM) to prevent and treat a host of common ailments — giving an important stamp of approval to healing practices that have long resided at the fringe of conventional medicine.
The endorsement comes from no less august an authority than the National Institutes of Health. In 1999, Congress established the National Center for Complementary and Alternative Medicine at the NIH; its sole aim was to rigorously assess the restorative powers of natural products, such as herbs and supplements, as well as mind and body therapies, like hypnosis and acupuncture. Thousands of studies and more than a decade later, "the science shows which approaches work," says Josephine Briggs, MD, director of NCCAM.
The proven therapies have much to recommend them. They are gentle on your body and can often replace prescription drugs. They're a safe adjunct (hence their "complementary" moniker) to medication and other conventional treatment. And they're easy on your wallet, usually less expensive than traditional care and, increasingly, covered by insurance. Here are some common conditions that new research says respond best to these uncommon — but extraordinarily effective — treatments.
Massage for depression
It's a no-brainer: Chronic mental and emotional stress, both of which can lead to depression, are eased by massage, so it's hardly a surprise that a number of studies conclude that massage therapy helps lift the blues. Researchers suspect that massage spurs the release of mood-boosting endorphins, perhaps in response to both physical manipulation and intimate hands-on touch. Some studies show that massage therapy is as effective as prescription antidepressants, such as Prozac and Paxil, in relieving anxiety, a major contributor to depression.
Hidden benefit: Massage therapy relieves stiffness and pain and speeds healing of sports injuries.
Tai Chi for insomnia
Are you a chronic tosser and turner? Can't sleep beyond the first chirps and tweets of the morning chorus? Try tai chi. The slow, meditative exercise regimen, originally developed as a martial art in China more than 2,500 years ago and practiced widely across Asia today, improves sleep quality in adults with moderate insomnia, CAM researchers say. The benefits, linked to tai chi's well-established ability to reduce stress, kicked in after participants practiced the routine for 16 weeks. You will need regular instruction at first, so look for classes at your Y or gym.
Hidden benefit: Tai chi helps improve balance and reduce risk of falling.
Bromelain for swelling
The indigenous peoples of South America have used bromelain for centuries to dress and treat wounds. Now, recent research confirms that a medicinal compound (today taken in a pill) extracted from the stem and juice of the pineapple plant speeds healing of acute injuries such as cuts and bruises. It works by stopping the production of prostaglandins, hormonelike compounds that are by-products of inflammation, improving blood circulation at the injury site. In Germany, bromelain is routinely given to patients before and after surgery to minimize swelling around incisions. "Be sure to take the enteric-coated version, which has a protective shell that helps get the pill beyond your digestive tract," says Tieraona Low Dog, MD, director of the fellowship for the Arizona Center for Integrative Medicine at the University of Arizona. It usually takes 1 to 2 days for bromelain to work. Caveat: Because it thins the blood, talk with your doctor first about using bromelain if you also take a blood thinner.
Hidden benefit: Bromelain is a digestive enzyme (it's also used as a meat tenderizer) and so helps ease indigestion if taken with food.
Acupuncture for chronic pain
A rash of new research affirms this ancient therapy as a powerful head-to-toe pain reliever for a wide range of conditions. After as few as six sessions, people who suffered from regular tension headaches saw their symptoms disappear. Another new study found that sufferers of chronic lower-back pain who received acupuncture fared better than those receiving conventional care. Acupuncture also relieves pain and improves mobility in people with osteoarthritis of the knee — encouraging news, because the condition is considered irreversible. Just how does acupuncture work? According to precepts of Chinese medicine, placing needles at specific points along the body's meridians, or energy channels, balances energy flow. Western scientists have a more prosaic explanation: The needles stimulate the body to release its own natural opioids, quelling pain. As their discomfort eases, sufferers of arthritis and lower-back pain can then perform exercises that enable them to regain strength, flexibility, and mobility.
Hidden benefit: You gain deeper body knowledge. Your acupuncturist will take a holistic approach to your condition, so although you may go in to treat pain in one part of your body, you may come out with a much broader understanding of how other parts contribute to that discomfort as well.
Glucosamine/chondroitin for joint pain
It works, it doesn't work... Over the years, the data on glucosamine and chondroitin, natural compounds found in healthy cartilage and available in supplement form, and their ability to reduce joint pain has been conflicted at best. The NCCAM study analyses finally bring clarity to the issue: Glucosamine is most effective in sulfate form; combined with chondroitin, it reduces joint pain in people with moderate-to-severe arthritis but is less helpful for those who have mild discomfort. Dosage is important too, the researchers have learned: A combination pill totaling 1,500 mg of glucosamine sulfate and 1,200 mg of chondroitin, taken daily, provides the most relief.
Hidden benefit: Glucosamine sulfate can stop the progression of osteoarthritis.
Cocoa for hypertension
Delectable news: Consumed daily for at least 2 weeks, cocoa (the darker the better) can reduce blood pressure among people with severe hypertension. Researchers say cocoa plant flavanols, called epicatechins, improve blood vessel function by helping artery walls relax. Most research shows the effects to be modest but still important, meaning you should use cocoa as an adjunct to any blood pressure meds, such as diuretics or ACE inhibitors, that you may be taking now. If you try it, follow the protocols used in most studies: Get the equivalent of 450 mg of flavanols, about the amount found in a cup of hot cocoa, twice a day.
Hidden benefit: Like chocolate, cocoa is rich in antioxidants, nutrients that fight cancer, strengthen the immune system, and slow aging. And — need we say it? — cocoa is delicious!
Green tea for rheumatoid arthritis
Although the findings so far are limited to laboratory animals, intriguing new research points to green tea's ability to marshal the body's defenses against rheumatoid arthritis. When consumed daily over 3 weeks, green tea decreased the likelihood that rats injected with a human form of rheumatoid arthritis would get the disease. Researchers credit the brew's polyphenols, a kind of antioxidant that can help bolster immunity. They say the popular libation could be an effective nutritional strategy in managing the condition in people. Caveat: Green tea contains a small amount of vitamin K, a clotting agent that can interfere with the effectiveness of anticoagulants, such as warfarin and heparin. If you take one of these drugs, tell your doctor, as he may need to adjust your dosage.
Hidden benefit: Some studies indicate green tea may help spur weight loss.
Rhodiola for anxiety
One reason we know that rhodiola (Rhodiola rosea) works is because it's been used worldwide for centuries, especially in Russia, Scandinavia, and Iceland (it grows in extreme northern climates), to quell anxiety and strengthen mental stamina. Another is that the Journal of Alternative and Complementary Medicine recently gave it a big thumbs-up. If you try this plant extract, also known as golden root and available at health-food stores, follow label directions. Caveat: It can cause dizziness and dry mouth, though these side effects are rare.
Hidden benefit: Rhodiola also counters symptoms of fatigue.
Hypnosis for hot flashes
Women who were hypnotized during five weekly sessions reduced both the frequency and severity of their hot flashes, according to fascinating new research. Experts say hypnosis can literally change the way the brain receives signals from the body and from the outside world. "Hypnosis teaches us that we have more control over how we process both internal and external information, like temperature, than we usually give ourselves credit for," says David Spiegel, MD, associate chair of psychiatry and behavioral sciences and medical director of the Stanford Center for Integrated Medicine. "For instance, hypnosis can suggest to the brain that it should tamp down its sensitivity to heat; when it does just that, women with hot flashes have an altered perception of their body temperature."
Hidden benefit: Hypnosis can decrease anxiety and depression and improve your quality of sleep.
Source: MSNBC News | | NHS should use term fat instead of obese, says minister Fri 30th July 2010 | GPs and other health professionals should tell people they are fat rather than obese, England's public health minister says.
Anne Milton told the BBC the term fat was more likely to motivate them into losing weight.
She said it was important people should take "personal responsibility" for their lifestyles.
But health experts said the word could stigmatise those who are overweight.
Ms Milton, who stressed she was speaking in a personal capacity, said:
"If I look in the mirror and think I am obese I think I am less worried [than] if I think I am fat."
She said too many staff working in the NHS were worried about using the term, but suggested it could help encourage "personal responsibility".
"At the end of the day, you cannot do it for them. People have to have the information," she added.
The minister spoke to the BBC after setting out the coalition government's vision for public health.
A white paper is expected to be published in the autumn, which she said would stress the combined role of the individual, state, business and society.
The comments come after Health Secretary Andrew Lansley last month attacked the "lecturing" of recent public health campaigns, such as the drive on school meals that followed Jamie Oliver's TV shows.
'More brutal'
Professor Steve Field, of the Royal College of GPs, said he agreed with Ms Milton and already tried to use the term fat as much as he could.
"I think the term obese medicalises the state. It makes it a third person issue. I think we need to sometimes be more brutal and honest.
"You can be popular by saying the things people want to hear and in the NHS we too often do that when we should be spelling things out clearly."
But Professor Lindsey Davies, president of the UK Faculty of Public Health, which represents public health professionals, warned against using 'fat' when dealing with patients.
"People don't want to be offensive. There is a lot of stigma to being a fat person."
She said health professionals started using the term obesity to encourage patients to think about the condition in a different way.
"Obesity is something that happens to people rather than something they are. The language you use all depends on the relationship you have with a patient.
"I would probably be more likely to say something like 'can we talk about your weight' rather than obesity, but that is a judgement you make on a patient-by-patient basis."
Source: BBC | | Shocking Blood Pressure Stats For Youngsters Fri 30th July 2010 | More than five million young Britons are in danger of developing high blood pressure, according to a new study.
Almost 9,000 people aged between 16-34 took part in the research, and of those, some 35% revealed high blood pressure readings.
Alarmingly, 4% of them had readings which showed severe or very severe hypertension.
The recommended blood pressure reading is 120/80 but the average for the UK is higher in general.
Around one in 10 adults over the age of 55 show signs of severe or very severe hypertension, putting themselves at serious risk of a heart attack or stroke.
"Although we must bear in mind that a one-off blood pressure test is not conclusive, cumulatively the average readings were higher than anticipated," said Lloydspharmacy's clinical pharmacist Shafeeque Mohammed.
"It was particularly worrying to see the number of younger people with readings that put them in the hypertensive category. We would certainly want to explore this further."
While stress could be a factor in the blood pressure rise, Mr Mohammed told Sky News Online it was probably more likely to be because of the increasingly sedentary lifestyle young people lead.
"There are obvious things that can be done - doing more exercise, for example," he said, "and also cutting back on salt, that's one of the biggest requirements for those who have high blood pressure.
"It is something that most people don't think they need to worry about until later in life, but it can affect you at any age.
"It often has no symptoms until it has become extremely severe, so it's vital to have your blood pressure tested regularly."
:: The study was carried out for Lloydspharmacy.
Source: Sky News | | New health policy: encouraging friendships? Thu 29th July 2010 | WASHINGTON (Reuters) - Having good social relationships -- friends, marriage or children -- may be every bit as important to a healthy lifespan as quitting smoking, losing weight or taking certain medications, U.S. researchers reported on Tuesday.
People with strong social relationships were 50 percent less likely to die early than people without such support, the team at Brigham Young University in Utah found.
They suggest that policymakers look at ways to help people maintain social relationships as a way of keeping the population healthy.
"A lack of social relationships was equivalent to smoking up to 15 cigarettes a day," psychologist Julianne Holt-Lunstad, who led the study, said in a telephone interview.
Her team conducted a meta-analysis of studies that examine social relationships and their effects on health. They looked at 148 studies that covered more than 308,000 people for their analysis, published in the Public Library of Science journal PLoS Medicine at http://www.plosmedicine.org.
Having low levels of social interaction was equivalent to being an alcoholic, was more harmful than not exercising and was twice as harmful as obesity.
Social relationships had a bigger impact on premature death than getting an adult vaccine to prevent pneumonia, than taking drugs for high blood pressure and far more important than exposure to air pollution, they found.
"I certainly don't want to downplay these other risk factors because of course they are very important," Holt-Lunstad said. "We need to start taking social relationships just as seriously."
PEOPLE INCREASINGLY ISOLATED
Government policies to encourage social relationships will not necessarily be easy, Holt-Lundstad said. "Air pollution and the clean air act -- that is simple policy," she said.
But she has some ideas -- such as making it easier for friends or relatives to take part in medical care, and city planning that encourages interaction.
The different studies measured social interaction in different ways, so the researchers said it was impossible to precisely define positive social interaction.
It equally difficult to study systematically, as it is impossible to randomly assign people to have friends or not have friends. But Holt-Lundstad said there is some evidence that assigning caretakers does not help improve people's health.
"Naturally occurring relationships may be different than support received from someone who is hired for that purpose," she said.
Her team found some troubling evidence that Americans are becoming more isolated, and thus losing the support and care that love and friendship provide.
"For instance, trends reveal reduced intergenerational living, greater social mobility, delayed marriage, dual-career families, increased single-residence households, and increased age-related disabilities," they wrote.
"More specifically, over the last two decades there has been a three-fold increase in the number of Americans who report having no confidant," they added.
"Such findings suggest that despite increases in technology and globalization that would presumably foster social connections, people are becoming increasingly more socially isolated."
Source: Reuters | | Drinking alcohol can 'reduce severity' of arthritis Thu 29th July 2010 | Drinking alcohol can 'reduce severity' of arthritis
Drinking alcohol can not only ease the symptoms of rheumatoid arthritis it appears to reduce disease severity too, research suggests.
Scientists at the University of Sheffield asked two groups of patients with and without the disease to provide details of their drinking habits.
They found that patients who had drunk alcohol most frequently experienced less joint pain and swelling.
Experts say this should not be taken as a green light for drinking more.
In the study, 873 patients with rheumatoid arthritis (RA) were compared to 1,004 people who did not have it.
Both groups were asked how often they had drunk alcohol in the month running up to the start of the study.
Patients completed a detailed questionnaire, had X-rays and blood tests, and a nurse examined their joints.
'Less damage'
Dr James Maxwell, consultant rheumatologist and lead author of the study, explained the findings.
"We found that patients who had drunk alcohol most frequently had symptoms that were less severe than those who had never drunk alcohol or only drunk it infrequently."
X-rays showed there was less damage to their joints, blood tests showed lower levels of inflammation, and there was less joint pain, swelling and disability in those patients, the researchers found.
They say they do not yet understand why drinking alcohol should reduce the severity of RA, and people's susceptibility to developing it. Dr Maxwell said:
"There is some evidence to show that alcohol suppresses the activity of the immune system, and that this may influence the pathways by which RA develops.
"Once someone has developed RA, it's possible that the anti-inflammatory and analgesic effects of alcohol may play a role in reducing the severity of symptoms," he added.
The authors say that further research is needed to confirm the results of the study and to investigate how and why alcohol has an effect on rheumatoid arthritis.
Risk and rewards
Previous studies have shown that alcohol may reduce the risk of developing the disease in the first place.
Similarly, in the current study non-drinkers were four times more likely to develop RA than people who drank alcohol on more than 10 days a month.
A spokeswoman for Arthritis Research UK, which co-funded the research, said:
"We would not want people with RA to take this research to mean that they should go out and start drinking alcohol frequently and in large amounts as this could be detrimental to their health."
She said some RA treatments, like the immunosuppressant drug methotrexate, can damage the liver when taken with large amounts of alcohol.
The patients in the study did not drink more than the recommended limit of 10 units of alcohol a week.
Source: BBC | | Herbal remedy could improve memory Thu 29th July 2010 | Southern Cross Univeristy School of Health and Human Science lecturer Annette Morgan.
IF your memory is not what it once was a herbal remedy could help, according to new research by academics at Southern Cross University.
The research, which was published last week and presented over the weekend at the International Conference on Herbal Medicine at Tweed Heads, has provided evidence the herb popularly known as brahmi improves memory performance in adults.
Bacopa monnieri, or brahmi, which has been commonly used for many years in Indian traditional medicine to promote intellect and longevity, was tested in a controlled trial of almost 100 healthy Australians over the age of 55 years – the largest study to date on the herb.
Southern Cross University's School of Health and Human Sciences lecturer Annette Morgan said the results of the research could have implications for the future treatment and prevention of dementia.
"We conducted validated neuropsychological tests and found that participants taking 300mg of baccopa monnieri extract each day for 12 weeks showed improved memory acquisition and delayed recall skills," Ms Morgan said.
"The probability of these improvements being simply chance was calculated to be only one in 10,000 for some of the results, and the findings support all previous studies so there is now strongly significant scientific evidence to show that it really works.
"For people past middle age experiencing memory difficulties, this herb can help support mental performance.
"We are facing a dementia epidemic, so the next logical step would be to carry out more trials to see if the same benefits can be shown in people with mild dementia."
Source: Northern Star | | Mental health experts ask: Will anyone be normal? Wed 28th July 2010 | LONDON (Reuters) - An updated edition of a mental health bible for doctors may include diagnoses for "disorders" such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.
Leading mental health experts gave a briefing on Tuesday to warn that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now for publication in 2013, could devalue the seriousness of mental illness and label almost everyone as having some kind of disorder.
Citing examples of new additions like "mild anxiety depression," "psychosis risk syndrome," and "temper dysregulation disorder," they said many people previously seen as perfectly healthy could in future be told they are ill.
"It's leaking into normality. It is shrinking the pool of what is normal to a puddle," said Til Wykes of the Institute of Psychiatry at Kings College London.
The DSM is published by the American Psychiatric Association (APA) and contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is seen as the global diagnostic bible for the field of mental health medicine.
The criteria are designed to provide clear definitions for professionals who treat patients with mental disorders, and for researchers and pharmaceutical drug companies seeking to develop new ways of treating them.
Wykes and colleagues Felicity Callard, also of Kings' Institute of Psychiatry, and Nick Craddock of Cardiff University's department of psychological medicine and neurology, said many in the psychiatric community are worried that the further the guidelines are expanded, the more likely it will become that nobody will be classed as normal any more.
"Technically, with the classification of so many new disorders, we will all have disorders," they said in a joint statement. "This may lead to the belief that many more of us 'need' drugs to treat our 'conditions' -- (and) many of these drugs will have unpleasant or dangerous side effects."
The scientists said "psychosis risk syndrome" diagnosis was particularly worrying, since it could falsely label young people who may only have a small risk of developing an illness.
"It's a bit like telling 10 people with a common cold that they are "at risk for pneumonia syndrome" when only one is likely to get the disorder," Wykes told the briefing.
The American Psychiatric Association did not immediately respond to a request for comment.
The scientists gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders.
This, they said, had "contributed to three false epidemics" of these conditions, particularly in the United States.
"During the last decade, how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn't really need it?," their statement asked.
Millions of people across the world, many of them children, take ADHD drugs including Novartis' Ritalin, which is known generically as methylphenidate, and similar drugs such as Shire Plc's Adderall and Vyvanse. In the United States alone, sales of these drugs was about $4.8 billion in 2008.
Wykes and Callard published a comment in The Journal of Mental Health expressing their concern about the upcoming DSM revision and highlighting another 10 or more papers in the same journal from other scientists who were also worried. DSM 5 is due to be published in May 2013.
Source: Reuters | | Homeopathy will not be banned by NHS despite critical report Tue 27th July 2010 | Homeopathy will continue to be available on the NHS despite an influential health committee condemning it as medically unproven.
Health minister Anne Milton said complementary and alternative medicine "has a long tradition" and very vocal people both in favour of it and against it.
A report by a group of MPs said homeopathic medicine should no longer be funded on the NHS and called for a ban on the medicines carrying medical claims on their labels.
The Commons Science and Technology Committee said there is no evidence the drugs are any more effective than a placebo - the same as taking a sugar or dummy pill and believing it works.
Last month, doctors attending the British Medical Association (BMA) annual conference backed this view, saying homeopathic remedies should be banned on the NHS and taken off pharmacy shelves where they are sold as medicines.
The treatment was described as "nonsense on stilts" and that patients would be better off buying bottled water.
Ms Milton said the Government welcomed the MPs' report but "remain of the view that the local National Health Service and clinicians are best placed to make decisions on what treatment is appropriate for their patients".
These decisions should take account of safety, and clinical and cost effectiveness, she said, adding that the Government remained committed to providing good-quality information on the treatments.
Homeopathy, which dates back 200-years, has been funded on the NHS since the service's inception in 1948.
It differs from herbal medicine in that it relies on substances being diluted many times, something the MPs said could not be scientifically proved to work.
There are four homeopathic hospitals in the UK, in London, Bristol, Liverpool and Glasgow.
Estimates on how much the NHS spends on homeopathy vary, with the Society of Homeopaths putting the figure at £4 million a year including the cost of running hospitals.
Former Liberal Democrat MP Evan Harris, who was a member of the Science and Technology Committee when it published its report, said: "This is not a good start for the new Health Secretary when it comes to evidence-based policy.
"How does the Government justify allowing treatments that do not work to be provided by the NHS in the name of choice, when it allows medicines which do work to be banned from NHS use?"
Source: Daily Telegraph
| | The New Nutritionist: Your Grocer Tue 27th July 2010 | A number of grocery retailers are now pushing nutritional advice. Efforts include posting nutritional ratings on bin labels and hiring dietitians to advise shoppers on how to select healthier food.
Myra Vanderpool for years regularly bought her local supermarket's store-brand wheat bread. This spring, she switched brands.
What prompted Ms. Vanderpool's move was a new nutritional-scoring system being tested at her Kroger Co. grocery store in Lexington, Ky., that ranks thousands of foods on a scale of 1 (low in nutrition) to 100 (really healthy). The results, posted next to items on the grocer's shelf, were eye-opening: Her regular bread scored a 23, the same as Häagen-Dazs coffee ice cream.
Ilan Brat/The Wall Street Journal On the NuVal scale used in some stores, Jif's Simply Creamy Peanut Butter scores a 23 on a scale from 1 to 100 (the higher the number, the healthier the food).
So the 67-year-old substitute teacher started buying one of Nature's Own wheat breads, which has a score of 81, partly because it contains more fiber and protein than her former brand. Ms. Vanderpool said her husband complains at times that he misses his old bread, but she tells him: "This is healthier for you."
Kroger's scoring system is part of a nationwide move by grocery retailers to get pushier about offering nutritional advice. Other chains, such as Hy-Vee Inc. in the Midwest, are hiring dietitians to advise shoppers on how to select healthier food and, in some stores, walk the aisles offering personalized recommendations for a fee. Some grocers, like Safeway Inc., are mining data gleaned from loyalty cards on their customers' purchasing habits to recommend healthier alternatives to the foods they buy. Wal-Mart Stores Inc., the country's biggest food retailer, plans to announce details of its own "nutrition program" later this summer, said a spokeswoman, who declined to elaborate.
Supermarkets are hoping to increase their shoppers' loyalty, and perhaps win back some customers who have turned for at least some of their purchases to specialty stores such as Whole Foods Market Inc. and big-box retailers like Wal-Mart. Sales of natural and organic foods jumped 72% to $31.9 billion in the five years ended 2009, while functional, or fortified, foods rose 44% to $37.3 billion in the same period, according to Nutrition Business Journal. And big food makers have been rolling out more options that are lower in salt and saturated fat and higher in fiber and whole grains.
"It's not our responsibility to tell shoppers what to eat, what not to eat or how to eat," said Ric Jurgens, chief executive of supermarket chain Hy-Vee. Still, "we need to provide them with as much information as we can, to help them make good decisions and provide as many options as possible."
Some food makers object to their products being scored for nutrition. They say shoppers consider a variety of factors when buying food. And they say that relying on a single nutritional score can make it difficult for consumers to understand how the foods they buy fit into a diet. It also can result in surprises, like the wheat bread Ms. Vanderpool bought that scored the same as an ice cream. A spokesman for the nutritional-scoring system, called NuVal, said calcium and vitamin A boosted the ice cream's score, while added sodium and low-fiber content hurt the bread's ranking.
Kellogg Co.'s Kashi brand in a statement said it tries to provide minimally processed, organic-certified food free of artificial flavors and other additives. "Many of the current nutrient-profiling systems don't take these values into account, which results in an incomplete picture," it said.
Kroger, the second-largest food retailer by revenue after Wal-Mart, recently began testing the NuVal scoring system in some Kentucky stores and is considering using it nationally. The system, developed by health experts from Yale University and other institutions, uses nutrition data on food labels and other public information to calculate how well a product helps meet federal dietary recommendations. High levels of saturated fat, for example, can pull down the score while calcium can help raise it. Foods are ranked from 1 to 100; the higher the number, the greater the nutritional value.
Retailers pay a fee to license the scoring system from NuVal LLC, which is owned by Griffin Hospital in Derby, Conn., and retailing cooperative Topco Associates LLC. The hospital owns the algorithm on which the system relies and only a seven-member panel of health and food experts from various universities can modify it. Other regional grocers that use NuVal, including Hy-Vee, Price Chopper Supermarkets, Meijer Inc. and Giant Eagle Inc., are members of the Topco cooperative.
NuVal's developers say the strength of the system is mainly in showing how one product brand or variety can be more nutritious than another. General Mills Inc.'s Cascadian Farm french fries, for instance, get a score of 76, while McCain Foods crinkle-cut french fries score a 26. A McCain spokeswoman said the company isn't familiar enough with NuVal to comment.
A NuVal spokesman said the McCain fries have more sodium and saturated fat than the Cascadian Farms product. He said food makers aren't shown the scores before they appear on grocers' store shelves.
Some food makers object to their NuVal scores. General Mills' Cheerios, for instance, scores a 37, while Original-flavor Post Shredded Wheat, made by Ralcorp Holdings Inc., gets a 91. "We do not believe that Shredded Wheat should be rated above Cheerios," a General Mills spokeswoman said in an email. She noted the nutritional value of Cheerios, including that it is low in fat and cholesterol-free, and that its No. 1 ingredient is whole-grain oats, but declined to elaborate. A NuVal spokesman said Cheerios has less fiber and more sodium per serving than does Shredded Wheat.
The scores can influence shoppers' choices. Ron Gill, a 44-year-old insurance salesman in Lexington, Ky., keeps an eye on the NuVal scores posted at his local Kroger store. On a recent shopping trip, in the processed-meat aisle, Mr. Gill passed up his usual Ball Park brand hotdogs, made by Sara Lee Corp., with a score of 7. Instead, he picked up Johnsonville Sausage LLC.'s smoked turkey sausage, which had a score of 10.
"It's a little difference, going in the right direction," Mr. Gill said.
A Sara Lee spokesman in a statement said other Ball Park products score higher on the NuVal scale.
Food retailers also are using other scoring systems to rank products by their nutritional quality. Northeast grocer Hannaford Supermarkets, a unit of Delhaize Group, in 2006 began marking its products with as many as three stars when they meet certain nutritional criteria. The company said sales of starred items have increased, but that only 25% of the stores' products merit even one star.
Some chains, including Hy-Vee, Kroger and Wegmans Food Markets Inc., are hiring registered dietitians to make nutrition recommendations in their stores. About half of Hy-Vee's 230 outlets post signs next to certain foods with a picture of the dietitian that spotlight the "Dietitian Picks" of the month. Shoppers can also pay $60 for an hour-long consultation with the dietitian and a personalized store tour.
Ilan Brat/The Wall Street Journal In-store dietitian Leigh Lettieri Brian helps Beth Dugan check ingredients at a Kroger market in Kentucky.
Julie Eich, 38, an accountant from Des Moines, Iowa, paid $150 for six one-on-one sessions with her Hy-Vee store's dietitian in May. Ms. Eich, who said she often opted for fast food because of her busy schedule, learned, for instance, that the low-calorie granola bar she thought was "all healthy and good" actually packed the sugar of a candy bar. "I had just been looking at calories but not where those calories came from," she said.
Some grocers are beginning to tap data on their customers' shopping habits built up from loyalty cards for use with nutritional programs. At Safeway, the third-largest food retailer, customers who sign up for the program online can go to "My Household's Snapshot" page and view the nutrient levels of the household's purchases over the past six months, shown on green vertical bars. A red horizontal line shows whether the purchases exceed, meet or lag behind federal guidelines.
Several chains, including ShopRite, a supermarket cooperative, and Giant Eagle, have tested using loyalty-card data to hand out coupons at the cash register for lower-calorie alternatives to shoppers who have recently bought the full-calorie versions and are considering introducing the system in their stores.
Source: The Wall Street Journal
| | Education 'helps brain compensate for dementia changes Tue 27th July 2010 | People who stay in education for longer appear to be better able to compensate for the effects of dementia on the brain, a study suggests.
A UK and Finnish team found those with more education were as likely to show the signs of dementia in their brains at death as those with less.
But they were less likely to have displayed symptoms during their lifetime, the study in Brain said.
Experts said scientists now had to find out why the effect occurred.
Over the past decade, studies on dementia have consistently shown that the more time you spend in education, the lower the risk of dementia.
But studies have been unable to show whether or not education - which is linked to higher socio-economic status and healthier lifestyles - protects the brain against dementia.
Compensation
The researchers in this study examined the brains of 872 people who had been part of three large ageing studies.
Before their deaths they had also completed questionnaires about their education.
The researchers found that more education makes people better able to cope with changes in the brain associated with dementia.
Post-mortems showed the pathology - signs of disease - in the brains of people with and without long educations were at similar levels.
But the researchers found those with more education are better able to compensate for the effects of the condition.
It also showed that, for each year spent in education, there was an 11% decreased risk of developing dementia.
Dr Hannah Keage of the University of Cambridge, who co-authored the study, said: "Previous research has shown that there is not a one-to-one relationship between being diagnosed with dementia during life and changes seen in the brain at death.
"One person may show lots of pathology in their brain while another shows very little, yet both may have had dementia.
"Our study shows education in early life appears to enable some people to cope with a lot of changes in their brain before showing dementia symptoms."
'Dementia resistant'
The researchers used data from the Eclipse collaboration, which combines the three European population-based longitudinal studies of ageing from the UK and Finland which have assessed people for up to 20 years.
Professor Carol Brayne, who led the study, said: "Education is known to be good for population health and equity.
"This study provides strong support for investment in early life factors which should have an impact on society and the whole lifespan.
"This is hugely relevant to policy decisions about the importance of resource allocation between health and education."
Ruth Sutherland, chief executive of the Alzheimer's Society, said: "This is the largest study ever to confirm that hitting the books could help you fight the symptoms of dementia in later life. What we don't know is why a longer education is so good for you.
"It could be that the types of people who study longer have large brains which adapt better to changes associated with dementia.
"Another reason could be that educated people find ways of managing or hiding their symptoms."
She added: "We now need more research to find out why an education can make the brain more 'dementia resistant'. Until then the message appears to be stay in school."
Rebecca Wood, chief executive of the Alzheimer's Research Trust, added:
"During dementia, proteins build up in the brain and nerve cells become damaged. This research suggests that education is not able to stop the damage but enables the brain to cope better and alleviate its impact. "
Source: BBC | | Mom was right: You are what you eat Mon 26th July 2010 | We are what we eat. We've all heard it, but most of us probably don't quite believe it. After all, you've had french fries and didn't sprout french fry antennae. So we're not really what we eat ... are we?
We are. It's every bit as true as it is hard to see. Just as our homes are made from lumber without looking like trees, our bodies are made from the nutrients we extract from foods without resembling those foods. The nutritional content of what we eat determines the composition of our cell membranes, bone marrow, blood, and hormones. Consider that the average adult loses roughly 300 billion cells to old age every day and must replace them. Our bodies are literally manufactured out of the food we consume.
That's why what we put in them is of utmost importance — and why "clean food" is an urgent priority and "junk" food is neither cute nor innocuous. In short, our bodies are only as clean as the food we feed them.
What difference does that make? Nothing less than this: Our forks — and our feet — are the master levers of medical destiny. Let me explain.
Before 1993, a list of the leading causes of death in the United States included heart disease, cancer, and stroke. But in that year, J. Michael McGinnis, MD, and William Foege, MD, changed this paradigm when they published "Actual Causes of Death in the United States" in the Journal of the American Medical Association, which looked at the causes of these diseases.
They concluded that fully half the annual deaths — roughly a million — were premature and could've been postponed by modifying behaviors, including smoking, diet and exercise, alcohol consumption, use of firearms, sexual behavior, motor vehicle crashes, and illicit drug use. Smoking and poor eating and exercise habits alone accounted for 700,000 premature deaths in 1990.
In 2004, a group of scientists at the CDC revisited this issue in JAMA and came to the same conclusion. This time, however, the toll from eating badly had gone up, due to obesity and diabetes.
Then, last summer, CDC scientists published a paper in the Archives of Internal Medicine analyzing records of more than 23,000 German adults enrolled in the European Prospective Investigation into Cancer and Nutrition study (EPIC) and investigated four behaviors: Are you eating well? Are you a healthy weight? Are you physically active? Do you smoke?
Those with four good answers (eating well, body mass index below 30, active, not smoking), compared with those with four bad answers (not eating well, BMI above 30, not active, and smoking), were 80 percent less likely to have any major chronic disease. (Imagine if a pill could reduce our risk of dying prematurely from any cause by 80 percent!)
You have doubtless heard of nature (genes) versus nurture (environment) — but this shows that lifestyle is so powerful, we can use it to nurture nature, or influence our genes. Various studies have shown this, but Dean Ornish, MD, and his colleagues have produced the most compelling results. Assigning men with prostate cancer to a "clean living" intervention that included a wholesome, plant-based diet; regular physical activity; and stress management, they demonstrated a marked reduction in the activity of genes that can promote prostate cancer growth and a significant increase in the genes that are able to control it.
That's the power and promise in clean eating, so it helps to know what it means. Is it organic? Not necessarily. Food can be organic without being nutritious — think organic gummy bears — or nutritious without being organic, such as conventionally grown broccoli. Organic is a good thing, but it's not a summary measure of "clean."
Clean foods are minimally processed and as direct from nature as possible. They're whole and free of additives, colorings, flavorings, sweeteners, and hormones. I particularly like foods with one-word ingredients, such as spinach, blueberries, almonds, salmon, and lentils. The longer the ingredient list, the more room there is for manufacturing mischief — additions of chemicals, sugar, salt, harmful oils, and unneeded calories — and the more likely it is that you should step away from the package so no one gets hurt!
There's also strong evidence that, as a rule, the closer to nature you eat, the fewer calories it will take for you to feel satisfied. The reason? Processed foods often have low amounts of fiber and water; a high ratio of calories to nutrients; and a mix of tastes from added sugar, salt, and flavoring that overly stimulates the appetite center in the hypothalamus. Clean foods are the opposite: lots of fiber and fluid, a high ratio of nutrients to calories, and free of added flavors — all of which send signals of satiety to your brain before you consume too many calories. As an example, think of how many raw almonds you eat before stopping, then compare that to honey roasted almonds — that sugary coating spurs you to eat more. By eating clean, you can control your weight permanently without feeling deprived or hungry or having constant cravings.
So, let's sum up the importance of eating clean. Our bodies are replacing billions of cells every day — and using the foods we consume as the source of building materials. Eating well is part of the formula that can reduce our risk of any major chronic disease by 80 percent and reach into our innermost selves to improve the health of our very genes.
Source: MSNBC news | | Britain Plans to Decentralize Health Care Mon 26th July 2010 | LONDON — Perhaps the only consistent thing about Britain’s socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate.
Andrew Testa for The New York Times
The new British government’s plan to drastically reshape the socialized health care system would put local physicians like Dr. Marita Koumettou in north London in control of much of the national health budget.
Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.
Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.
The plan would also shrink the bureaucratic apparatus, in keeping with the government’s goal to effect $30 billion in “efficiency savings” in the health budget by 2014 and to reduce administrative costs by 45 percent. Tens of thousands of jobs would be lost because layers of bureaucracy would be abolished.
In a document, or white paper, outlining the plan, the government admitted that the changes would “cause significant disruption and loss of jobs.” But it said: “The current architecture of the health system has developed piecemeal, involves duplication and is unwieldy. Liberating the N.H.S., and putting power in the hands of patients and clinicians, means we will be able to effect a radical simplification, and remove layers of management.”
The health secretary, Andrew Lansley, also promised to put more power in the hands of patients. Currently, how and where patients are treated, and by whom, is largely determined by decisions made by 150 entities known as primary care trusts — all of which would be abolished under the plan, with some of those choices going to patients. It would also abolish many current government-set targets, like limits on how long patients have to wait for treatment.
The plan, with many elements that need legislative approval to be enacted, applies only to England; other parts of Britain have separate systems.
The government announced the proposals this month. Reactions to them range from pleased to highly skeptical.
Many critics say that the plans are far too ambitious, particularly in the short period of time allotted, and they doubt that general practitioners are the right people to decide how the health care budget should be spent. Currently, the 150 primary care trusts make most of those decisions. Under the proposals, general practitioners would band together in regional consortia to buy services from hospitals and other providers.
It is likely that many such groups would have to spend money to hire outside managers to manage their budgets and negotiate with the providers, thus canceling out some of the savings.
David Furness, head of strategic development at the Social Market Foundation, a study group, said that under the plan, every general practitioner in London would, in effect, be responsible for a $3.4 million budget.
“It’s like getting your waiter to manage a restaurant,” Mr. Furness said. “The government is saying that G.P.’s know what the patient wants, just the way a waiter knows what you want to eat. But a waiter isn’t necessarily any good at ordering stock, managing the premises, talking to the chef — why would they be? They’re waiters.”
But advocacy groups for general practitioners welcomed the proposals.
“One of the great attractions of this is that it will be able to focus on what local people need,” said Prof. Steve Field, chairman of the Royal College of General Practitioners, which represents about 40,000 of the 50,000 general practitioners in the country. “This is about clinicians taking responsibility for making these decisions.”
Dr. Richard Vautrey, deputy chairman of the general practitioner committee at the British Medical Association, said general practitioners had long felt there were “far too many bureaucratic hurdles to leap” in the system, impeding communication. “In many places, the communication between G.P.’s and consultants in hospitals has become fragmented and distant,” he said.
The plan would also require all National Health Service hospitals to become “foundation trusts,” enterprises that are independent of health service control and accountable to an independent regulator (some hospitals currently operate in this fashion). This would result in a further loss of jobs, health care unions say, and also open the door to further privatization of the service.
The government has promised that the new plan will not affect patient care and that the health care budget will not be cut. But some experts say those assertions are misleading. The previous government, controlled by the Labour Party, poured money into the health service — the budget is now about three times what it was when Labour took over, in 1997 — but the increases have stopped. The government has said the budget will continue to rise in real terms for the next five years, but it is unlikely that the increases will keep up with the rising costs of care and the demands of an aging population.
“The real mistake that is being made by the health secretary is to drive through an ideologically determined program of reorganization which is motivated by the principle of efficiency savings,” said Robin Durie, a senior lecturer in politics at the University of Exeter. “History shows clearly that quality will suffer as a consequence.”
Dr. Durie added, “The gulf between the rhetoric of the white paper and the technicalities of what is involved in the various elements of the overall reorganization being proposed is just extraordinary.”
For example, he asked, how will the government make good on its promise to give patients more choice — a promise that seems to require a degree of administrative oversight — while cutting so many managers from the system?
“How will the delivery of all this choice be funded?” Dr. Durie asked. “And how will the management of the delivery of choice be funded?”
Dr. Vautrey said the country needed to have a “mature debate about what the N.H.S. can and cannot afford.”
He said: “It is a sign of the mixed messages that government sends out. They talk about choice and competition and increased patient expectations at the same time as they tell the service they need to cut costs and refer less and prescribe less. People need to understand that while the needs of everyone may be met, their wants will be limited.”
As they prepare for the change, many doctors are wondering whether it will be permanent this time around.
“Many of our colleagues have seen this cycle of change repeatedly,” Dr. Vautrey said. “Many would look at previous reorganizations and compare it to this one and wonder how long the current change will last before the next one comes along.”
Source: The New York Times
| | Benin priest turns to Japan for medical mission Sat 24th July 2010 | Father Obossou Kochole Etienne from Benin has a dream: researching foreign herbal remedies and then seeking out local equivalents “to develop cheap medicines tailored for African bodies.”
The first step, however, involves obtaining a doctorate in Japan.
It hasn’t been easy: living alone in Yokohama, this 39-year old priest from Dassa-Zoume now scrimps and saves just to afford textbooks.
He sometimes studies until 3 a.m. and has developed acute enteritis from malnutrition and overwork.
Father Obossou embarked on his mission after a harrowing experience while working as hospital chaplain.
“I would offer the Sacraments, give spiritual support and try to care for souls. But then, in one week, a typhoid epidemic at the hospital killed 30 people.”
He then tried to determine the cause of the high mortality rate. It turned out to be a combination of lack of medicine, inexperience in administering them and the actual medicines themselves.
His discovery also raised other issues.
The medicines were from abroad and too expensive for many people. The drugs - developed for Americans and Europeans - also caused adverse side effects due to differences in African physiology. In addition, the medicines had degraded due to lack of protection from the local heat and humidity.
In response, Father Obossou asked medical professionals and villagers to bring whatever natural remedies they knew to the hospital. When some patients recovered from “alternative” treatments, he became determined to study them and other natural forms of medicine.
This led him to kanpo-yaku, the Japanese adaptation of traditional Chinese herbal medicine that uses over 210 different types of preparations.
Father Obossou first arrived in Japan in 2006 and spent a year studying agriculture at the Asian Rural Institute, an ecumenical agricultural school in Tochigi Prefecture. After a brief visit home to pass on what he had learned, he returned to Japan to study Japanese before enrolling at his current university in 2008.
Life in Japan has been a struggle for Father Obossou, but with the assistance of the Paris Foreign Missions Society, compatriots and Japanese Catholics, he is confident his endeavors will one day benefit many people back home in Africa.
Source: ucanews.com
| | What "clinically proven" means for a beauty product Sat 24th July 2010 | NEW YORK (Reuters Health) - Science doesn't just help to invent new products, it can push existing ones.
Look no further than the beauty industry. It does lots of testing and flaunts products with scientific terms like microbeads, enzymes and rejuvenating serums. But what are the data behind them? And what if the company selling the product did the tests?
Take Inneov Sun Sensitivity, a nutritional supplement "clinically proven" to protect your skin from the sun's harmful UV rays while leaving you with a nice tan, according to its maker Laboratoires Inneov, a joint venture between L'Oreal and Nestle.
The pill combines lycopene and beta-carotene -- the red and orange substances in tomatoes and carrots, respectively -- with a probiotic reported to impact the skin's response to UV light.
"The efficacy of our nutritional supplement was demonstrated by rigorous studies," said Nathalie Piccardi, of Laboratoires Inneov, who worked on the study.
"The next step is to present this product to dermatologists," she told Reuters Health, noting it has already been launched in Europe and South America.
But a closer look reveals some shaky science, said Dr. Peter Schalock, a dermatologist at Massachusetts General Hospital in Boston who isn't affiliated with Laboratoires Inneov.
"Scientifically there are no data there," he said about one of the company's experiments. "It sounds like opinion and nothing more."
NO DIRECT COMPARISONS
The only published data on the tanning pill's ability to reduce sunburns came out last month in the British Journal of Dermatology. To test the pill, scientists had dozens of women expose their behinds or backs to strong UV light. They found an effect on immune cells in the skin, but the question was, would the women also get fewer sunburns and better tans?
To answer that, Laboratoires Inneov conducted a so-called randomized controlled trial -- the most powerful kind of study in the scientific toolbox -- in which women were randomly assigned to take Inneov Sun Sensitivity or a placebo pill.
But the researchers never compared the response directly between the two groups, the whole point of a randomized controlled trial. Instead, they used a weaker method comparing the before-and-after differences within each group.
While Piccardi said she thought this method was appropriate, it means the company can't claim women taking their product had a higher threshold for sunburns than those taking a placebo pill. The same goes for the tan.
As a result, said Schalock, the company's claim that women taking their product can sunbathe with less concern of getting burned might be a stretch.
Schalock told Reuters Health he has a "hard time seeing that statistically or scientifically they have proven it."
COMPANY FUNDED RESEARCH
The fact that the company did the testing itself could also raise a red flag.
"There is some evidence to indicate that we are right to be concerned about the quality of research when there is a conflict of interest," said Josephine Johnston, a bioethicist at the Hastings Center in Garrison, New York.
Johnston, who said she could not speak to the scientific merits of the Inneov report, said other studies had shown industry-funded research is more likely to have positive outcomes, and that people could be influenced by financial interests even if they didn't realize it.
"The major problem," she told Reuters Health, "is that it has an impact of trustworthiness."
Branding personal care products with clinical claims is a very common strategy, an expert who studies consumer marketing told Reuters Health.
"Claiming that kind of a benefit is certainly something people respond to," said the expert, a professor at an East Coast university who asked to remain anonymous because his institution receives funding from the cosmetics industry.
While some people will want to see and feel an impact, he said, for many the clinical claim alone suffices. "The key question is, will the consumer view as credible that ingesting a pill will prevent (sun) damage?"
WHAT DID SKIN DOCTORS FIND?
In another experiment, Laboratoires Inneov scientists gave the tanning pill to 80 women and asked them to sunbathe as they normally would over the summer, applying sunscreen at their discretion.
Then they asked dermatologists, recruited by a company paid by Laboratoires Inneov, a series of questions about how these women fared. According to the report, the dermatologists told Laboratoires Inneov the product prevented sunburns.
"We truly believed that this kind of study, taking into account consumers' opinion, complements experimental and control studies," said Piccardi.
But the study did not answer a number of questions: How did the women usually do in the summer? Did they end up like boiled lobsters or were they careful not to get burned? Might they have been extra cautious because they were part of a skin protection study?
"It would have been nice to really know that it worked, and that it's not just a placebo effect," Schalock said.
He pointed out it was hard to draw any conclusions from this part of the study because it didn't include any data. What kind of evaluations did the dermatologists do? What exactly did they tell Laboratoires Inneov?
Of more than a dozen researchers and dermatologists contacted about the quality of this study, only Schalock agreed to comment.
Dr. Tobias W. Fischer, a dermatologist at the University Lubeck in Germany, offered this rationale for why he didn't: "I don't give interviews, criticizing other researchers' work, even if industrial."
The editor of the journal that published the study, Dr. Tanya Bleiker, said it had been reviewed by experts before acceptance, as are all the journal's reports.
While there had been some concerns about the methods, "on balance there was enough interest to publish it," she told Reuters Health.
NO CONFLICTS OF INTEREST?
The journal does ask researchers if they have financial ties to the products they are studying. According to Bleiker, "the authors stated very clearly that there was no conflict of interest."
However, more than half of the authors work for Laboratoires Inneov, as indicated on the cover page of the report.
"It wasn't being hidden that they worked for the company," Johnston told Reuters Health. "The journal knew it."
"The question for the journal, given that the authors worked for the company, is, 'Do we publish something like that?'"
Johnston said there was an ongoing debate about whether or not scientists who review studies should know about potential industry interests.
The question then becomes what, if anything, to do when there is a conflict of interest.
"The reader can't do anything," said Johnston. "It needs to be done by people higher up in the food chain."
Whether or not Inneov Sun Sensitivity has been "clinically proven" to protect against sunburns, "We have to deal with the fact that the scientific literature contains research from people with financial conflicts," Johnston said.
SOURCE: http://link.reuters.com/vaj98m British Journal of Dermatology, online June 9, 2010.
| | Bone 'turnover' link to diabetes Sat 24th July 2010 | The skeleton has a key role in regulating blood sugar and may be the underlying cause of diabetes in some people, say US researchers.
A study in mice found that the breakdown of old bone to make way for new bone growth also helps to keep a healthy level of glucose in the blood.
A hormone called osteocalcin seems to be the link, it showed.
The Columbia team, writing in Cell, say the findings may lead to better drugs to help control Type 2 diabetes.
Study leader Dr Gerard Karsenty, from Columbia University Medical Center, had already done work showing osteocalcin, which is released by bone, can regulate glucose levels.
It switches on the production of insulin in the pancreas which in turn improves the ability of other cells to take in glucose from the blood.
But in the latest study, he found that osteocalcin only works when bone is being broken down during its natural turnover.
Further tests on osteocalcin and glucose levels in a small group of patients with a genetic defect in their bone turnover supported the initial findings in mice.
'Important implications'
Type 2 diabetes is the most common form of the condition and is caused when the body no longer properly responds to insulin leading to out of control blood sugar.
The results suggest that for some people, diabetes may be triggered by changes in the skeleton.
Also drugs designed to stimulate this link between bone and insulin may lead to better treatments for type 2 diabetes, he adds.
One important consequence of the finding is that bone-strengthening drugs used in conditions such as osteoporosis may interfere with this process and cause problems with blood sugar.
"This research has important implications for both diabetes and osteoporosis patients," he said.
"First, this research shows that osteocalcin is involved in diabetes onset
"Secondly, bone may become a new target in the treatment of type 2 diabetes as it appears to contribute strongly to glucose intolerance
"And finally, osteocalcin could become a treatment for type 2 diabetes."
Dr Victoria King, head of research at Diabetes UK, said: "The research is interesting and this area of investigation could open up the possibility of more targets for drugs to treat or prevent type 2 diabetes."
But she warned the research was in the very early stages.
"What we do know at this stage is that lifestyle changes such as maintaining a healthy weight, eating a balanced diet and being more physically active can help to reduce your risk of developing type 2 diabetes, and can also help people diagnosed with the condition to manage it more effectively."
Source: BBC
| | Heart risk factors less common in fish lovers Fri 23rd July 2010 | NEW YORK (Reuters Health) - Middle-aged and older men who eat fish every day are less likely than infrequent fish eaters to develop a collection of risk factors for heart disease, diabetes and stroke, a new study suggests.
Whether a fishy diet itself is the reason for the benefit is not clear from the findings.
But, the researchers say, the results are in line with studies showing that omega-3 fatty acids -- found most abundantly in oily fish like salmon, mackerel and albacore tuna -- may have heart benefits.
Clinical trials have shown, for instance, that omega-3s can lower triglycerides (a type of blood fat), and a prescription medication containing the fats -- sold as Lovaza -- is sometimes used to treat very high triglyceride levels.
Research has also suggested that fish oil supplements can help lower blood pressure and may reduce the risk of death among people with established heart disease, according to the National Institutes of Health.
The new study, of 3,500 Korean adults ages 40 to 69, found that men who had a serving of fish each day were 57 percent less likely than those who dined on fish less than once per week to develop metabolic syndrome over three years.
Metabolic syndrome refers to a collection of risk factors for diabetes, heart disease and stroke -- including abdominal obesity, high blood pressure, high blood sugar, low HDL cholesterol and high triglycerides. The syndrome is typically diagnosed when a person has three or more of those traits, and the National Health and Nutrition Examination Survey, a major study, found that it can double the risk of heart attack and stroke.
Past research had linked higher fish intake to a lower risk of some individual components of metabolic syndrome. But the current study is the first to show an association with the collection of risk factors, according to the researchers, led by Dr. Inkyung Baik of Kookmin University in Seoul.
They found that of 232 men who said they ate fish every day at the study's outset, 29 -- or about 12 percent -- developed metabolic syndrome over the next three years. Of the 190 men who said they ate fish less than weekly, 16 percent developed metabolic syndrome.
When Baik's team considered other factors -- including the men's income and education, body weight and lifestyle habits such as smoking and exercise -- daily fish consumption was linked to a 57 percent lower risk of metabolic syndrome versus less-than-weekly consumption.
There was no such association seen among women, however.
The reason for the gender discrepancy is not clear. The researchers speculate that, as a group, women may not have gotten enough omega-3 fatty acids from fish to show a reduction in the risk of metabolic syndrome.
Men in the top 10 percent for omega-3 intake from fish typically got 786 milligrams (mg) per day, while their female counterparts got 563 mg.
Men in that top omega-3 group also showed a lower risk of metabolic syndrome than those in the bottom 10 percent -- which, according to Baik's team, supports the theory that it is the fats that explain the connection between fish and the risk of metabolic syndrome.
However, this type of study cannot by itself prove cause-and-effect.
"Our findings need to be confirmed by other investigators," Dr. Chol Shin, one of the researchers on the study and a professor at Korea University Ansan Hospital, told Reuters Health in an email.
And in general, it is not yet clear what the optimal daily intake of omega-3 fatty acids might be, Shin noted.
In the U.S., there is no recommended daily allowance set for EPA and DHA, the two major omega-3 fatty acids, writes registered dietitian Gretchen K. Vannice, in an editorial published with the study.
However, she adds, the American Dietetic Association and other groups have suggested a daily allowance of anywhere from 250 to 500 mg of EPA and DHA, based on the overall body of research into omega-3s and heart health.
Two servings of fatty fish per week would be enough to achieve those levels, Vannice notes.
That also fits in with the current advice from the American Heart Association that adults strive to eat two servings of fish, preferably fatty varieties, each week.
However, even if eating fish regularly does help reduce the risk of metabolic syndrome or its components, it would be only one of many factors involved. A healthy weight, not smoking, regular exercise, and a balanced diet rich in fruits, vegetables, high-fiber foods and "good" unsaturated fats are all considered important.
The current study was funded by Kookmin University and a Korean government grant. Vannice is a nutrition research consultant who has consulted for companies that market omega-3 supplements.
SOURCE: http://link.reuters.com/jur98m Journal of the American Dietetic Association, July 2010.
| | 'Cut down on meat to lose weight' Fri 23rd July 2010 | Eating less meat may be the key to keeping a healthy weight, say researchers.
A European study of almost 400,000 adults found that eating meat was linked with weight gain, even in people taking in the same number of calories.
The strongest association was found with processed meat, such as sausages and ham, the Imperial College London team reported.
It suggests that high-protein diets may not help slimmers in the long run.
The findings, published in the American Journal of Clinical Nutrition, also support public health messages advocating cutting down on the amount of meat we eat, the researchers said.
The study looked at data from adults taking part in a large project looking at the link between diet and cancer.
Participants from 10 European countries, including the UK, were weighed and measured at the start and then asked to report their weight five years later.
They also filled in a detailed food questionnaire.
Weight gain
Overall, the researchers found that meat consumption was associated with weight gain in both men and women.
More detailed analyses showed that the link was still significant after taking into account overall calorie intake, physical activity and other factors which may have skewed the results.
The team calculated that in people who ate the same number of calories, an extra 250g of meat a day - equal to a small steak - led to an additional weight gain of 2kg (5lbs) over five years.
It counters the theory that diets with high amounts of protein and low amounts of carbohydrate promote weight loss.
Although it is not clear why meat would lead to weight gain in people eating the same number of calories, one theory is that energy-dense foods like meat alter how the body regulates appetite control.
But there could also be another lifestyle or dietary explanation for the link that was not accounted for by the study.
Study leader Dr Anne-Claire Vergnaud said: "I would recommend to people to control their consumption of meat to maintain a healthy weight and good health in general during life."
But she added: "Decreasing the amount of meat alone would not be an adequate weight loss strategy."
Sian Porter, a dietician and spokeswoman for the British Dietetic Association, said there were caveats in the study, including the fact that at the end-weight was self-reported.
But she said it was an interesting finding.
"We eat more meat than we need.
"What I say to my patients is to think about variety - so have an egg for breakfast instead of bacon, cheese for lunch instead of ham and fish for the evening meal.
She advised people to eat lots of lentils and pulse, wholegrains, fruit and veg and oily fish as well as meat.
"Portion size is the other thing - a portion of meat should be about the size of a deck of cards."
Source: BBC | | Urine in Public Pools Could Cause Cell Damage Fri 23rd July 2010 | Public swimming pools are more dangerous than you might think, a new study suggests. When sweat and urine, among other organics, mix with the disinfectants in pool water, the result can be hazardous to health.
The findings, announced this week, link the application of disinfectants in recreational pools to genetic cell damage that has been shown to be linked with adverse health outcomes such as asthma and bladder cancer.
Pool water represents extreme cases of disinfection that differ from the disinfection of drinking water as pools are continuously exposed to disinfectants. But with so many people cooling off and exercising in pools and water parks (339 million visits across the United States each year), the disinfectants are a must to prevent outbreaks of infectious disease.
Chlorine and Pee Don't Mix
The problem occurs when the sanitizers mix with organic matter.
"All sources of water possess organic matter that comes from decaying leaves, microbes and other dead life forms," said study researcher Michael Plewa, University of Illinois professor of genetics. "In addition to organic matter and disinfectants, pool waters contain sweat, hair, skin, urine and consumer products such as cosmetics and sunscreens from swimmers."
These consumer products are often nitrogen-rich, and when mixed with disinfectants, these products may become chemically modified and converted into more toxic agents.
Long-term exposure to these disinfection byproducts can mutate genes, induce birth defects, accelerate the aging process, cause respiratory ailments, and even induce cancer, according to the researchers. While the new study did not examine actual effects on humans, it suggests such research might be warranted.
Pool Samples
In this study, researchers evaluated water samples from public pools and a control sample of tap water. They tested whether the byproduct chemicals in the samples could induce gene mutations using a so-called systematic mammalian cell genotoxicity analysis.
This sensitive DNA technology can detect genomic damage in mammalian cells, allowing researchers to investigate damage at the level of each nucleus within each cell.
Results proved that all disinfected pool samples had more genomic DNA damage than the source tap water, Plewa said.
The findings are published in the journal Environmental Science & Technology. The work was supported by grants from the National Science Foundation.
Cleaner Pools
All this doesn't mean you need to ditch your pool plans. Plewa offers recommendations for pool operators and swimmers to reduce hazardous chemicals and make for safer pool water.
"Care should be taken in selecting disinfectants to treat recreational pool water," Plewa advised.
"The data suggest that brominating agents should be avoided as disinfectants of recreational pool water. The best method to treat pool waters is a combination of UV treatment with chlorine as compared to chlorination alone."
In addition, organic carbon should be removed prior to disinfection when the pool water is being recycled, Plewa said.
Swimmers can also help by showering before entering the water, which would mean fewer organics and so reduce the genotoxicity of the pool water. One recommendation that may seem obvious: Don't pee in the pool. Plewa suggests pool owners remind patrons about the potential harm caused by urinating in a pool.
Source: Fox News | | Some caffeine okay during pregnancy: obstetricians Thu 22nd July 2010 | NEW YORK (Reuters Health) - A cup of coffee a day during pregnancy probably won't increase a woman's risk of miscarriage or premature birth, The American College of Obstetricians and Gynecologists said today.
Until recently, studies have had conflicting findings about the effect of moderate caffeine consumption on pregnancy complications.
But, "I think it's time to comfortably say that it's okay to have a cup of coffee during pregnancy," Dr. William Barth, the chair of a College committee which reviewed the evidence, told Reuters Health.
The College's Committee on Obstetric Practice said that 200 milligrams of caffeine a day, about the amount in a 12-ounce cup of coffee, doesn't significantly contribute to miscarriages or premature births. That definition of "moderate caffeine consumption" would also include drinking about four 8-ounce cups of tea or more than five 12-ounce cans of soda a day, or eating six or seven dark chocolate bars.
The committee said the evidence was not clear on whether consuming more than 200 mg of caffeine a day might increase pregnancy risks.
The group considered two recent studies, each of which followed more than 1,000 pregnant women. One study, led by Dr. David Savitz of The Mount Sinai Medical Center in New York, found no increased rate of miscarriage for women who consumed low, moderate, or high levels of caffeine at different points in their pregnancy.
In the other, Dr. De-Kun Li and his colleagues at Kaiser Permanente's Division of Research in Oakland found a higher risk of miscarriage in women who consumed more than 200 mg of caffeine per day, but no extra risk at lower levels.
The committee also pointed to two other studies that found that a mother's moderate caffeine intake did not make it any more likely she would deliver a baby prematurely.
Research has shown that caffeine is able to cross the placenta, which led to worries that it could cause miscarriage or premature birth. "It's not inert, it does have drug-like properties," Savitz, who was not involved in producing the guidelines, told Reuters Health. And, he said, "it justifiably deserves a close look because it's so widely used."
In the U.S., about 16 percent of all pregnancies end in miscarriage and about 12 percent of babies are born prematurely.
Previous studies, Barth said, were mixed and unclear about the link between caffeine and pregnancy risks. It was the new findings from large groups of women that allowed the committee to feel confident that moderate caffeine intake was safe, and "try to bring some conclusion to the subject," he said.
The committee statement goes along with the thinking that caffeine is "not an all-or-nothing sort of thing," Savitz said. While some women may choose to cut out caffeine altogether during pregnancy, others might care a lot about that daily cup of coffee and just try to cut back a little - and both options are okay, he said.
Li said that while the committee report is balanced, he would recommend erring on the side of safety - even for low levels of caffeine consumption.
The committee's opinion could help women make choices during pregnancy, Savitz said. "It's not either shocking or alarmist or changing radically what we thought before," he said. "But sometimes I think it's important for authoritative groups to issue these kinds of statements. I think it can be a helpful guideline to physicians and I also think it can be helpful to women themselves."
SOURCE: http://link.reuters.com/tyx58m Obstetrics & Gynecology, online July 21, 2010.
| | Good cholesterol may mean little for statin users Thu 22nd July 2010 | CHICAGO (Reuters) - People with high levels of the so-called good cholesterol HDL tend to have fewer heart attacks but HDL may offer little protective benefit in people who take statins to lower harmful LDL cholesterol, U.S. researchers said on Wednesday.
An analysis of a large study of healthy people who took AstraZeneca's statin drug Crestor to prevent heart attacks found having high HDL was not a good predictor of heart attack risk.
"HDL is a very powerful predictor of future risk" of heart disease, said Paul Ridker of Brigham and Women's Hospital in Boston, whose study appears in the journal Lancet.
But "once we get LDL into these very low ranges with very potent statins, HDL no longer predicts future risk of heart disease," he said in a telephone interview.
The findings raise questions about drugs in development to raise HDL to prevent heart attacks, he said.
Several companies are working on HDL-raising drugs, which would likely be combined with statins in hopes of developing even more potent weapons against heart disease.
Tiny Canadian biotech ResVerlogix has an experimental drug in clinical trials that increases production ApoA-1 in the blood, which then raises HDL -- a compound that helps ferry harmful fats out of the blood.
Raising HDL through increased ApoA-1 is a different approach from other HDL boosters, such as a class known as CETP inhibitors that included torcetrapib, Pfizer's most spectacular clinical failure. Merck & Co and Roche are still developing CETP inhibitors.
Current drugs that raise natural levels of HDL, such as niacin, cause unpleasant side effects such as flushing.
NO DIFFERENCE
In the original study, called JUPITER, patients with average to low levels of low-density lipoprotein or LDL were given Crestor or rosuvastatin, which cut their bad cholesterol concentrations to levels seen in Aboriginal populations but rarely seen in Western patients.
People in the study who took Crestor had 54 percent fewer heart attacks and 48 percent fewer strokes after two years compared with people who took a placebo.
In the new analysis, Ridker and colleagues looked to see if HDL was still a predictor of heart attack risk in people who took Crestor.
They found that HDL was still protective in people who got the placebo, but in those whose cholesterol was lowered by the statin, having high HDL made no difference in predicting which patients would have heart problems.
The findings suggest higher HDL concentrations may not be a good measure of heart risk in people who lower their bad cholesterol levels with statins, Dr. Derek Hausenloy of The Hatter Cardiovascular Institute at University College London said in a commentary.
"Whether increasing HDL cholesterol in patients with very low LDL cholesterol has any beneficial effects on cardiovascular risk remains to be shown directly in large randomized trials," he said.
Ridker agrees.
"In my heart of hearts, I believe the only way to address whether or not new agents that increase HDL will be effective is through well-done carefully taken out clinical trials. There is no other way to get there," he said.
Source: Reuters | | 'Toxic trio' triggers gut disease Thu 22nd July 2010 | The precise cause of the immune reaction that leads to coeliac disease has been discovered.
Three key substances in the gluten found in wheat, rye and barley trigger the digestive condition, UK and Australian researchers say.
This gives a potential new target for developing treatments and even a vaccine, they believe.
Coeliac disease is caused by an intolerance to gluten found in foods like bread, pasta and biscuits.
It is thought to affect around 1 in every 100 people in the UK, particularly women.
The link between gluten and coeliac disease was first established 60 years ago but scientists have struggled to pinpoint the precise component in gluten that triggers it.
The research, published in the journal, Science Translational Medicine, studied 200 patients with coeliac disease attending clinics in Oxford and Melbourne.
The volunteers were asked to eat bread, rye muffins or boiled barley. Six days later they had blood samples taken to measure their immune response to thousands of different gluten fragments, or peptides.
The tests identified 90 peptides that caused some level of immune reaction, but three were found to be particularly toxic.
Professor Bob Anderson, head of the Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia, said: "These three components account for the majority of the immune response to gluten that is observed in people with coeliac disease."
Coeliac disease can be managed with a gluten-free diet but this is often a challenge for patients. Nearly half still have damage to their intestines five years after starting a gluten-free diet.
Professor Anderson said one potential new therapy is already being developed, using immunotherapy to expose people with coeliac disease to tiny amounts of the three toxic peptides.
Early results of the trial are expected in the next few months.
Sarah Sleet, Chief Executive of the charity Coeliac UK, said the new finding could potentially help lead to a vaccine against coeliac disease but far more research was needed.
She said: "It's an important piece of the jigsaw but a lot of further work remains so nobody should be expecting a practical solution in their surgery within the next 10 years."
The symptoms of coeliac disease vary from person to person and can range from very mild to severe.
Possible symptoms include diarrhoea, nausea and vomiting, recurrent stomach pain, tiredness, headaches, weight loss and mouth ulcers.
Some symptoms may be mistaken as irritable bowel syndrome or wheat intolerance.
Source: BBC
| | Autistic kids grow normally despite limited diet Wed 21st July 2010 | NEW YORK (Reuters Health) - Children with autism tend to be picky eaters, but a new study suggests that their growth may not be impaired because of it.
The study, which followed 79 UK children with autism spectrum disorders (ASDs) and nearly 13,000 autism-free children to the age of 7, found that although children with ASDs were more often rated as picky eaters by their parents, their average intake of calories and major nutrients was similar to their peers'.
Moreover, there were no differences in the two groups' weight and height attainment, researchers report in the journal Pediatrics.
"We think that these are reassuring findings, and that in general, parents of children with ASD symptoms need not worry that their children will not grow properly," Dr. Pauline Emmett, a senior research fellow at the University of Bristol in the UK, told Reuters Health in an email.
But, she noted, parents who are worried about their child's eating habits should bring it up with their doctor -- and can ask for a referral to a dietitian if they want more advice.
The term "autism spectrum disorders" refers to a group of developmental disorders that hinder people's ability to communicate and build relationships. The conditions range from severe cases of "classical" autism to Asperger's syndrome -- a disorder in which a person has normal intelligence and verbal skills, but difficulty socializing and understanding subtler forms of communication, like body language and vocal tone.
It's been known that children with ASDs often have unusual eating patterns or will only eat a limited selection of foods -- at least in part because of the general aversion to new experiences and the repetitive, ritualistic behaviors that mark the disorders.
But whether that tendency toward picky eating has consequences as far as growth and development has been unclear.
For the new study, Emmett and her colleagues used data from a long-term project that has followed the health of nearly 14,000 UK children since their birth in 1991 to 1992.
Of those children, 79 were diagnosed with an ASD at some point, including 30 with classical autism and 23 with Asperger's. The rest were diagnosed with "atypical" autism, which shares some of the features of classical autism but tends to be milder, or could not have their ASD classified.
Overall, children with ASDs had less varied diets than their peers, based on parents' responses to dietary questionnaires completed when their children were 6 months, 15 months and 2, 3 and 4 years old.
At the age of 4, for example, 37 percent of children with ASDs were deemed to be "very choosy" eaters, versus 14 percent of children without the disorders. Among those with ASDs, children with classical autism had more-limited diets than those with other ASD types.
However, the average intakes of calories, protein, fat and carbohydrates were all similar between children with ASDs and those without. And while children with the disorders tended to eat fewer vegetables and fruit than other children, they also drank less soda and ate fewer sweets.
There were also no differences between the two groups of children when it came to average height, weight and body mass index -- a measure of weight in relation to height -- or in blood levels of iron.
There were two differences in the children's diets overall: those with ASDs averaged less vitamin C -- probably, the researchers note, because they ate fewer fruits and vegetables -- and less vitamin D, which is obtained in the diet mainly from fortified milk products and fish.
Those vitamin gaps were not large, however, and were "unlikely to be important for the majority of the children," Emmett said.
Still, she added, the study looked at average differences between two groups of children; it's possible that some individual children with ASDs had deficiencies in vitamins C or
D.
The bottom line for parents, the researchers say, is that, despite their often-picky eating, children with ASDs seem to typically get enough major nutrients and grow normally.
They do point out, however, that if children with ASDs have "extreme" limits on what they will eat, it may signal an eating disorder that needs attention.
SOURCE: http://link.reuters.com/vur58m Pediatrics, online July 19, 2010.
| | ADHD meds help, but many parents still against them Wed 21st July 2010 | Medication may be the most effective treatment for kids with ADHD but it’s not a cure-all, a new Consumer Reports survey shows.
Parents surveyed by the magazine reported using a variety of strategies to improve their kids’ symptoms, such as hiring tutors, switching schools, modifying diets, and changing the way they spoke to their children.
The results are good news, says Dr. Orly Avitzur, a neurologist and medical adviser to the magazine. Kids improve the most when medication is coupled with complementary approaches, such as behavioral therapy and strategies to help with academics.
Consumer Reports interviewed 934 parents of children with ADHD, asking about a variety of topics, ranging from the impact of medications to the effect of complementary strategies, to which physicians provided the most help.
Most families — 84 percent — tried medication at some point, with 67 percent reporting that the drugs helped “a lot.” In general, kids who got a prescription for ADHD were older: The average age of children who had tried medication was 13.
Another strategy that got good marks was switching a child to a school that was better suited to handle ADHD. A full 45 percent of the parents who tried this approach said the switch helped “a lot.” A similar strategy, hiring a tutor, got thumbs up from 37 percent of the parents who tried it.
Parents also reported changing the way they interacted with their children. Some started giving their kids only one instruction at a time — that helped “a lot” for 39 percent of the parents who tried it.
Dietary link?
Other parents tried tweaking their child’s nutrition. Adding a vitamin supplement and paying more attention to what a child was eating helped “a lot” in 17 percent of families, while the addition of fish oil supplements got the highest marks from 12 percent of those who tried them.
Parents who suspect that diet has an impact on their children’s symptoms may have gotten some validation from a study published this month in the Journal of Attention Disorders. The study, which followed 1,799 kids from birth to age 14, found that kids had more than twice the risk of developing ADHD if they ate a “Western diet” that consisted of energy dense, heavily processed foods that were rich in saturated fat, salt and sugars and low in omega-3 fatty acids, fiber and folate.
There is some evidence that certain dietary factors — such as omega 3 fatty acids — may play a role in symptoms, says Patrick Tolan, a professor in the Curry School at the University of Virginia and director of Youth-Nex: The UVA Center to Promote Effective Youth Development. But it’s possible that studies that show a connection between ADHD and a bad diet may simply reflect other lifestyle factors, like parents who are very busy.
Tolan isn’t surprised to see parents searching for complementary strategies. “With medication, the child isn’t so distracted, and that makes it easier to learn,” Tolan says. “But it’s not going to teach the child problem-solving skills or give him the ability to stop and think things through like other kids do.”
Those are the kinds of skills a kid will get out of behavioral training and social skills training, Tolan says.
What was surprising about the new survey was how dissatisfied parents were with medications even while reporting that the ADHD drugs were very effective. Only 52 percent of parents agreed strongly that if they had to do it all over again, they would have their kids take medication. And 44 percent said they wished there was another way to help their child.
Those findings may have something to do with side effects, which were reported by 84 percent of the parents. That may be a sign that doctors aren’t spending enough time adjusting medications to get the least amount of side effects while maintaining effectiveness, says Avitzur.
“It’s not like you can just give the child a pill and you’re finished,” she explains. “There’s a lot more to it in terms of management.”
Some parents may just not like the idea of their kids being on a medication, says Alan Kazdin, the John M. Musser Professor of Psychology and Child Psychiatry at Yale University and director of the Yale Parenting Center.
“They think of it as a Band-Aid or a crutch,” Kazdin says. “But, I’ve heard from many, many children who couldn’t believe how well the medication worked, who were amazed at how they were now able to pay attention in class.”
Source: MSNBC News
| | Screening speech may aid autism diagnosis: study Tue 20th July 2010 | WASHINGTON (Reuters) - A device may be able to automatically screen young children for autism based on how they talk, U.S. researchers said on Monday.
The small recorder fits into a child's pocket and analyzes the words the child says during the day, and a software program evaluates how the child makes certain sounds.
A team of researchers led by Kimbrough Oller of the University of Memphis analyzed more than 3 million syllabic utterances, collected from almost 1,500 all-day recordings from 232 children aged 10 months to 4 years.
The program correctly identified an existing autism diagnosis 86 percent of the time. The analysis also predicted the age of a typically developing child, said the study published in the journal Proceedings of the National Academy of Sciences.
"Although clinicians have been saying for many years that they think that autistic kids sound strange when they talk, there's been no practical way to use vocalization as a part of the diagnostic or screening procedure in working with autism," said Oller, professor of audiology and speech-language pathology.
Oller identified the speech patterns the device analyzes and helped develop the screening method.
The tests were conducted in English, but Oller said the technique may apply to other languages. "It hasn't actually been tried yet, but there's every reason to think it should," he said.
Doctors now diagnose autism by testing children for a range of behavioral and speech issues including how much they talk by a certain age and whether they make eye contact with other people.
"Autism is a multi-factoral disorder and it has many behavioral dimensions to consider. And vocalization is clearly an important one," said Oller. "But I certainly don't think it should be used exclusively."
Oller, who studies language learning and language evolution, has identified how the formation of different syllables changes during a child's first four years.
Instead of saying "ba" as part of a longer word, for instance, a young child might at first say "ba-a," with "sort of a staccato or tremor kind of pattern," said Oller. The speech development of autistic children does not follow those typical patterns, the analysis shows.
The software distinguishes among speakers and processes sounds made only by the child being studied. The day-length recordings enable the researchers to examine a child's natural speech.
Parents send the recorder back to the company after the child has worn it for a day and the company analyzes the recording for language development progress and autism.
Infoture Inc developed the device and the software. The company dissolved in February 2009 and was reconstituted as the LENA Foundation, a not-for-profit organization, which continues to fund the research. The foundation sells the device along with clothing with a pocket to hold the recorder.
Oller received consultation fees from Infoture before it dissolved and several of the other researchers are employees of the LENA Foundation.
Source: Reuters | | Fish eaters show lower risk of age-related eye disease Tue 20th July 2010 | NEW YORK (Reuters Health) - Older adults who eat fatty fish at least once a week may have a lower risk of serious vision loss from age-related macular degeneration, a new study suggests.
The findings, reported in the journal Ophthalmology, do not prove that eating fish cuts the risk of developing the advanced stages of age-related macular degeneration, or AMD.
But they add to evidence from previous studies showing that fish eaters tend to have lower rates of AMD than people who infrequently eat fish.
They also support the theory that omega-3 fatty acids -- found most abundantly in oily fish like salmon, mackerel and albacore tuna -- may affect the development or progression of AMD.
AMD is caused by abnormal blood vessel growth behind the retina or breakdown of light-sensitive cells within the retina itself -- both of which can cause serious vision impairment. AMD is the leading cause of blindness in older adults.
There is no cure for AMD, but certain treatments may prevent or delay serious vision loss.
A U.S. government clinical trial found that a specific high-dose mix of antioxidants -- vitamins C and E, beta- carotene and zinc -- can slow the progression of AMD that is in the intermediate stages, and doctors now commonly prescribe it for such patients.
Whether fish or omega-3 supplements can stall AMD progression is not yet clear. But a follow-up to the U.S. antioxidant trial is now looking at whether adding fish oil and the antioxidants lutein and zeaxanthin to the original supplement regimen brings additional benefits.
For the current study, Bonnielin K. Swenor and colleagues at Johns Hopkins University in Baltimore analyzed data from 2,520 adults aged 65 to 84 who underwent eye exams and completed detailed dietary questionnaires.
Fifteen percent were found to have early- or intermediate-stage AMD, while just under 3 percent were in the advanced stage of the disease.
Overall, Swenor's team found, there was no clear relationship between participants' reported fish intake and the risk of AMD. However, there was a connection between higher intake of omega-3-rich fish and the odds of advanced AMD.
Study participants who ate one or more servings of such fish each week were 60 percent less likely to have advanced AMD than those who averaged less than a serving per week.
That was with factors like sex, race and smoking habits -- which have been linked to AMD risk -- taken into account; women appear to be at greater risk of AMD than men, while whites are at greater risk than African Americans and smokers face a higher risk than non-smokers.
Still, the findings do not prove that omega-3-rich fish bestowed the benefit.
"While the current research indicates that a diet rich in omega-3 fatty acids can reduce the risk of late AMD in some patients, more research is still necessary," Swenor told Reuters Health in an email.
She pointed out that this study was "cross-sectional" -- meaning it assessed participants at one time point, rather than following them over time to see whether self-reported fish eaters were less likely to develop AMD. So it is not clear whether participants' reported diet habits preceded the development of the eye disease.
The study also relied on people to accurately recall and report their typical eating patterns, which is subject to error.
Nor is it clear, Swenor said, why greater consumption of omega-3-rich fish was related to a lower risk of advanced, but not earlier-stage, AMD.
For now, she suggested that people with AMD discuss all their "dietary options" with their ophthalmologist.
In general, though, eating fish regularly is considered a healthy move. The American Heart Association, for example, recommends that all adults aim to eat fish, preferably fatty varieties, at least twice per week, for the potential benefits for heart health.
SOURCE: http://link.reuters.com/xut38m Ophthalmology, online July 13, 2010.
| | Mobiles may increase risk of tinnitus, study suggests Tue 20th July 2010 | Regularly using a mobile phone may increase the risk of tinnitus, which involves constant ringing or buzzing in the ear, a small study suggests.
Austrian researchers recruited 100 people with the condition and 100 without, and compared mobile phone use.
They found tinnitus was over 70% more likely in those averaging 10 minutes' daily phone use, reported Occupational and Environmental Medicine journal.
But the British Tinnitus Association said a link was unproven.
While intense noise, head trauma and certain drugs are all known to increase the risk of the ear condition, in many cases the reasons are unknown.
Researchers from the Medical University of Vienna said the evidence so far linking mobiles with tinnitus was anecdotal, but that their small study suggested at the very least it warranted further investigation.
Because of the widespread use of the devices, even a slightly increased risk would be of "public health importance", they wrote, particularly given that the condition can in some cases profoundly interfere with daily life.
It is thought about 10% of the population have some form of tinnitus, but it is unclear whether the condition is becoming more prevalent.
Ear energy
As well as the 70% increased risk from using a phone for more than 10 minutes a day, they found that having used a phone for more than 160 hours cumulatively was associated with a 60% increased risk.
But their study did throw up statistical anomalies, finding a lower risk among those who had made 4,000 calls or more than those who had made fewer.
The team acknowledged that asking people to recall their use was problematic, leading to both over-estimation and underestimation.
But lead author Dr Hans Peter Hutter said there were biological mechanisms by which mobiles could cause ear problems.
The cochlea, the spiral-shaped organ that translates sounds into electrical impulses the brain can understand, and the auditory pathway "are located in an anatomical region where a considerable amount of the power emitted by mobile phones are absorbed".
It is also possible that prolonged, constrained posture using a phone while walking and talking could affect blood flow in that side of the head.
These reasons are more likely than simply the sound of speech on the other end of the line.
Veronica Kennedy, a consultant and adviser to the British Tinnitus Association, said: "The association between tinnitus and electromagnetic fields is not a new idea with electromagnetic fields being put forward both as a cause and treatment for tinnitus.
"Some people have attributed their tinnitus to the sounds generated by electromagnetic fields within modern electrical wiring or power plants. Electromagnetic therapy has also been used to treat tinnitus. This is an interesting study but there are a number of complex factors underlying tinnitus which have not been addressed in the study.
"The link between mobile phone use remains unproven with further work still needed.
Source: BBC
| | Special Report: In austere times, can bribery be healthy? Fri 16th July 2010 | DUNDEE, Scotland (Reuters) - Moira Christie has to ring the doorbell when she goes to visit friends these days. That's a new thing for her. Until a few months ago, everyone knew she was coming because they could hear her hacking smoker's cough from far down the street.
"My cough was my calling card," the tiny 54-year-old Scot says with a laugh. "But not any more. I'm not coughing now. My friends and relatives can't believe it. They say 'You've never given up! You? Never!' -- but I have, I've done it, and I feel so much healthier already."
Christie is not only quieter and healthier, she's a little richer too. That's because the local health authority paid her to quit. The scheme is one of a clutch of experiments cropping up across Europe, the United States and parts of Latin America which use financial incentives -- cash payments, gift cards, shopping vouchers and the like -- to encourage or cajole people to drop their bad habits and live more healthily. "The underlying rationale of incentives is that healthier people are less costly to the system than sick ones," says Harald Schmidt at the Harvard School of Public Health.
The experiments have grown out of studies in the relatively new discipline of behavioral economics, which examines how emotional factors affect economic choices. Some public health experts are yet to be convinced that bribing people can work. But as healthcare costs keep rising in such heavyweight nations as the United States and heavy-smoking locations as Dundee, and as governments move to cut huge budget deficits, hundreds of local authorities, employers and health insurers -- even the occasional former investment banker -- are dabbling with health incentive schemes.
PAY NOW, SAVE LATER
The idea is simple: pay people to act now and governments will reap the rewards later in lower healthcare costs. Statistically speaking, people who shun harmful habits are more productive and have less need for expensive hospitals, doctors and medicines. By changing "habitual health-related behaviours," says Theresa Marteau, director of the Center for the Study of Incentives in Health and a psychology professor at King's College London, those behind the schemes aim to make more people healthier for longer. Specifically, "they're trying to tackle the big four that are responsible for most of the world's premature deaths and illnesses -- excessive eating, smoking, drinking and lack of exercise," says Marteau.
Many in Dundee are at risk from all four. Moira Christie had smoked for around 35 years by the time she joined her incentive programme, which is called Quit 4 U. The scheme is backed by Britain's National Health Service and was born out of a similar project, Give It Up For Baby, which aims to reduce shockingly high rates of smoking among mums-to-be in Dundee. In some of the poorest areas of the city up to 40 percent of pregnant women and half of all adults smoke, while rates of obesity and alcohol-related illness are among the highest in Europe.
"What we have here is a cocktail of influences on our most deprived communities who have the worst health -- a cocktail which ensures that trying to change their behavior through simplistic messages is just not going to work," says Andrew Radley, a public health expert who along with colleague Paul Ballard has championed Quit 4 U and is now overseeing its expansion into other areas. "You therefore have to work with them to come up with motivators that are actually part of their way of thinking."
Participants get 12.50 pounds ($19) on a grocery store card every week they stay off tobacco, building to a potential total of 150 pounds after three months. For mums-to-be who stay off cigarettes, the payments continue until the baby is three months old. Anyone who gets that far would take home 650 pounds. Participants in both schemes commit to regular carbon monoxide breath tests to prove they're not cheating.
The lure of extra cash has so far proved enough to get even some of the most die-hard tobacco addicts to quit. Margaret Robertson, a former 40-a-day smoker who attends the weekly breath test and support group sessions alongside Christie, is proud of the little nest egg she's nurturing. "I'm letting it build up until Christmas. That's when it'll really help," says Robertson, 61, who started smoking when she was 11 years old and has just completed her sixth smoke-free week in 50 years.
"MEGA UNHEALTHY"
When Dundee's first pilot project started in 2007, critics condemned the idea of incentives as little more than state bribery. So far, though, the results have been impressive: 12-week quit rates are more than double those achieved in any previous years.
By the end of the first year, 55 mothers in the city of Dundee, which has a population of 140,000, had quit smoking using the incentive scheme, and 140 had quit across the coastal Tayside region of eastern Scotland. The year before, just six pregnant women had made contact with Tayside's stop smoking services -- and none of them stayed in touch beyond four weeks.
Even these pilots can be cost-effective, argue Ballard and Radley. They put the overall cost per quitter at 1,700 pounds, which might sound a lot until you consider that smoking costs Britain's taxpayer-funded health system some 5 billion pounds a year according to a 2009 study by Oxford University researchers. Globally, the World Lung Foundation estimates the annual cost of smoking is $500 billion in medical expenses, lost productivity and environmental harm.
"The whole methodology of this incentive scheme is defined by community-based research. It is driven by what is of most value to the target audience," says Ballard. If you get it right, it can be "an approach that can really deliver results."
There is no doubt Scotland can do with the help. It is known, after all, as the land whose citizens don't just eat Mars Bars and pizza in perilously large amounts, but deep-fry them first. A study published last month found that almost the entire adult population of Scotland -- 97.5 percent -- have habits that are deemed "dangerous to health" including smoking, heavy drinking, taking no exercise, being overweight and eating a poor diet.
Ballard calls Dundee an "incredibly unhealthy" city in a "mega unhealthy" nation. In truth, the rest of the developed world is not much better. Obesity, smoking, alcohol and lack of exercise are causing more protracted and expensive diseases, and killing more residents of the rich world earlier, than anything else. The World Health Organization (WHO) predicts that by 2015, around 2.3 billion adults worldwide will be overweight and more than 700 million will be obese.
In Europe, the WHO reckons obesity alone is already responsible for up to 8 percent of all health costs and between 10 and 13 percent of deaths. Experts predict that in Britain almost nine out of 10 adults and two thirds of children will be overweight or obese by 2050. By then the medical bill and loss of productivity could top 50 billion pounds a year.
Little wonder that drug companies are spending billions of dollars searching for treatments and cures for cancers, diabetes and heart disease. But why develop drugs when the best thing we could do to improve our health is quit smoking, stop eating so much fat, salt and sugar, exercise more and cut back on alcohol? And if getting more people to do that is difficult, which of course it is, then why not pay them?
"INCENTIVES CULTURE"
Former investment banker Winton Rossiter is convinced paying people to get healthier is the next big thing. Rossiter, a 55-year-old American-born businessman who's lived in England for 20 years, has become one of the pioneers of British incentive schemes. Three years ago he founded a company called WeightWins which now promotes a scheme called "pounds for pounds".
"We earn incentives from shopping in certain places, flying certain airlines -- so why not get financially rewarded for doing something that's positive?" he says. "We're in an incentives culture where people need a reason to even think about getting healthy."
Rossiter's firm has been running a pilot scheme in Kent, southern England, where the taxpayer-funded local health authority asked him to help cut a 24 percent adult obesity rate. The programme works by adding up how much weight each participant has lost and how long it remains off. A sliding scale of payments is applied; those who lose the most and keep it off earn the most money.
Rossiter says his programme is already working. By last month, of the 402 people who started a "pounds for pounds" plan in the Kent scheme, 321, or 80 percent, had lost weight, while just 20 percent either stayed the same or gained weight. Less encouragingly, more than three-quarters of participants had dropped out by 12 months, meaning their progress, or lack of it, could not be counted in the final results.
Rossiter makes his money through a joining fee, which starts at 45 pounds sterling and goes up to 135 pounds, plus a monthly subscription fee of between 10 and 30 pounds. Participants can earn rewards of up to 3,000 pounds. To get that, they'd have to lose 150 pounds of weight over 21 months and keep it all off for at least three months.
"You get paid to lose weight -- two things people definitely want to do," he says.
In the Kent scheme, taxpayers footed the subscription bills via the local health authority. But Rossiter says the cost to local governments could be returned many times over. He's broken down British government data that estimated the annual cost of obesity at between 3.3 billion pounds sterling and 3.7 billion pounds. For every pound of obesity weight that is removed permanently, he says, the government saves 170 pounds in medical expenses and 1,200 pounds in lifetime economic costs. Kent paid Weight Wins around 12 pounds for every pound of fat lost.
WAITING FOR THE CALL
Public health scientists are less enthusiastic. "I think they can be useful in some instances, but it depends very much on how they're implemented," says Harvard's Schmidt. Both King's College's Marteau and Tammy Boyce, an expert at the King's Fund healthcare think-tank in London, say the Kent pilot was "not a proper trial" because it lacked the proper scientific procedures needed to evaluate the outcomes.
Marteau's sense is that the best evidence to support the use of incentives schemes can be found not in large, cross-societal groups, but in specific niches of unhealthy behavior where all the usual health messages have failed. Here, it seems, an immediate and relatively large reward may be enough to change a pattern. "The two places where incentives really have been found to be effective are in drug addict abstinence programmes, and in smoking cessation in pregnancy," she says. "And when you think about it, these are outliers" -- extreme, addictive behaviours generally shown by people on the margins.
Former banker Rossiter is undeterred. Frustrated by what he sees as dithering among public health officials, he is planning to take "pounds for pounds" direct to the public via the internet, where anyone can pay a joining fee and sign up to win cash rewards for slimming down.
"If obesity really is the public health crisis and the ticking timebomb that we keep hearing about, then we need to throw out some of our scepticism and prejudices and really push this thing forward," he says.
So sure is Rossiter that his scheme will work, he's ready to guarantee "long-term results" for any government in Europe prepared to back the scheme. "If Scotland wanted to put a million overweight people into my programme, I would guarantee long-term behavior change and weight loss or they would get their money back. But I'm still waiting for the call."
Perhaps he should meet Gianluca Buonanno, the flamboyant mayor of the small north-western Italian town of Varallo, and another big enthusiast of using health incentive schemes to make whole nations healthier.
A few years ago, Buonanno set up a plan which promised to pay oversized residents 50 euros ($70) for losing 3 to 4 kilograms in a month, a further 200 euros if they kept the weight off for 5 months, and yet more if they managed to keep their weight down for a year. The scheme, he says, was a great success, particularly for one 42-year-old woman who said she had become so fat that her husband "would not even look at her any more".
"Sixty percent of participants reached their objectives," Buonanno told Reuters. He's now lobbying in Italy's parliament for the plan to be scaled up across the nation. The results, "can't be measured only in prizes. If a person feels better, consumes less medicine, then the nation's entire health system gains."
"TRENDY IDEA"
The notion of health incentives has been popularised in the past few years by books like 'Nudge' and 'Freakonomics', which describe how such concepts as "behavioural economics" and "choice architecture" can be used to engineer people toward healthier habits. It's no coincidence that as the Obama administration started to show an interest in behavioural economics, one of the authors of Nudge, Cass Sunstein, joined the White House staff.
"Incentives are definitely becoming a very trendy method," says public health specialist Boyce, who has watched with dismay as governments have become excited by the idea of old-fashioned bribery. The idea, she says, allows politicians to cozy up to the powerful food and drinks industry lobby and duck out of writing tough legislation for better health. It satisfies many governments' desires to be libertarian and business-friendly and avoid slapping taxes on high-fat or high-sugar junk foods.
Britain's health minister, Andrew Lansley, said last week that the country's new coalition government does not believe in "lecturing or nannying" people to change their behavior, preferring a "non-regulatory approach". It has not indicated whether incentives may be a part of that.
Mike Kelly, director of public health at Britain's National Institute for Health and Clinical Excellence, which advises government on cost-effective health policies, says incentive schemes are popping up all over the place. So far, though, there isn't much in the way of hard scientific evidence about incentivising people for health. "If these things are going to go forward it ought to be on a proper evidence-based set of principles. And we desperately need to know whether it is a cost-effective option."
The London-based Evidence for Policy and Practice Information and Co-ordinating Center (EPPI-Center) published a review last year that found there were studies underway on around 130 incentives schemes globally. More than half were in the United States, with Britain, Germany and Mexico among active countries. It found around half the schemes were aimed at getting people to stop smoking, with healthy eating next and obesity targeted by a minority.
HEALTH INSURERS SEE POTENTIAL
In the United States, where healthcare is largely handled through private insurance companies, major employers such as Safeway and General Electric are also getting into incentives in a big way. In recent years they have begun paying bonuses or offering health insurance discounts to employees who give up bad habits or keep their weight and cholesterol levels in check. That, in turn, has spawned a clutch of new companies such as VirginHealthMiles and RedBrick Health, who sell "pay for prevention schemes" to big corporations.
In Germany, Barmer Ersatzkasse, a large sickness fund which insures around 6.8 million people, offers incentives to members who take part in any or all of 17 named healthy activities -- from turning up for immunisations to giving up smoking or going regularly to the gym. Members get a bonus card on which points are credited; anyone earning 500 or more points over two years can redeem them against such "healthy" prizes as cycle helmets or sports watches. Families can pool their points and trade them in for a bigger reward such as a Nintendo Wiifit console (1500 points) or even swap them for hard cash rewards of up to 30 euros a year per person.
The fund also offers schemes giving discounts on premiums to people who don't use health services that much -- a bit like a "no claims" bonus on a house or car insurance policy.
CARROT AND STICKS
The German plan highlights one of the potential disadvantages in such schemes: they may prove self-selecting. Harvard's Schmidt, who has studied health incentives in the United States and Germany, says incentives may not only improve insurance plan members' health -- so their costs go down -- but may also attract more healthy people in the first place. That risks leaving those in the poorest health, who are often also society's poorest financially, facing higher costs for the healthcare they urgently need.
That's just one of a broader set of problems that Schmidt sees as inherent in the incentives idea. Why should fat people get paid to do what thin people are doing already? Why should smokers who quit now get a bonus when those who quit last year didn't? If regular gym-goers were already quite happy to pay for it, why should taxpayers' money be used to subsidise others just in the hope a few more may be nudged in the same direction? Won't some people become adept at gaming the system?
Schmidt breaks those affected by incentive schemes into groups:
* the "lucky ones" -- those who already go to the gym regularly and will now get extra cash or prizes for doing so;
* the "yes I can" group, who find the incentive gives them exactly the nudge they needed;
* the "I'll do it tomorrow" group who never quite get around to it and feel punished by not being able to get the reward;
* the "unlucky ones" who have no hope of getting to a gym because of their work or family life or disability;
* and the "leave me alone" group which is self-explanatory.
For all but one or two of these groups, incentives would likely fail, Schmidt says, so using taxpayers' money to fund them doesn't look like much of a deal. "I don't have a problem with incentives if they work. But..." His voice trails off and he gives a shrug of the shoulders.
FOOLS RUSH IN?
What evidence there is from scientific assessments is not that encouraging either. Marteau cites a so-called Cochrane review -- a systematic analysis of previous peer-reviewed studies -- conducted in 2008 on using incentives to help people stop smoking. It found that none of the 17 trials it analysed had higher quit rates at six months when incentives were used.
On obesity, the findings are similar. A 2008 systematic review looking at eight weight-loss trials which were followed up for at least a year found that incentives had no positive effect on weight loss or weight maintenance at 12 or 18 months.
The King's Fund's Boyce worries that governments are starting up incentives plans before any proper scientific analysis has been done. "You wouldn't do this with a drug," she says, pointing out that many years, even decades, of trials and tests are conducted on medicines before they are distributed to the general public. "But for some reason we allow ourselves to get caught up in the moment and attach ourselves to ideas like this that don't really have a big evidence base."
BABY THOUGHTS
But such scepticism doesn't cut it with Rebecca Garside, who is 28 and just a few weeks off giving birth to her first baby. As part of Dundee's scheme to stop pregnant mums smoking, she's at her local pharmacy blowing into a carbon monoxide monitor to prove that despite 11 years as a smoker, she has finally given up.
As the blinking green light officially confirms her as a non-smoker, she strokes her swollen belly. Health statistics suggest her baby will now be a healthier weight and less likely to need intensive care after birth, and that both Garside and her child will be less likely to develop a range of costly chronic diseases like asthma, heart disease and cancer.
But Garside is thinking of the more immediate future. She is saving the "quit" credits on her supermarket gift card, she says, for "all those things I know I'll have to buy when the baby comes along."
"Buggies, nappies, and even my weekly food shopping. It'll definitely be a help."
Source: Reuters
| | Delay in Release of Study on Chronic Fatigue Syndrome Prompts an Outcry Fri 16th July 2010 | Researchers at the National Institutes of Health and the Food and Drug Administration, citing a need to re-evaluate their data, have delayed publication of a new study believed to provide evidence of a link between chronic fatigue syndrome and a little-known retrovirus
The study, already peer-reviewed, was supposed to appear in the prestigious Proceedings of the National Academy of Sciences. The delay has sparked an outcry on blogs and social networking sites among chronic fatigue patients, who are desperate for answers about their debilitating illness and fear that important scientific data are being suppressed.
“A cabal of top government administrators” with a habit of “heavy-handed, anti-science manipulation of peer-reviewed science” ordered the delay, Hillary Johnson, author of a book about the history of chronic fatigue syndrome, alleged on her Web site, OslersWeb.
Federal officials said publication was delayed because the findings contradicted those of the Centers for Disease Control and Prevention, which conducted its own study on chronic fatigue and the retrovirus, known as XMRV. The C.D.C. study, which found no connection, was initially also held up for reassessment because of the discrepancies, but was eventually published on July 1 in the journal Retrovirology.
A spokeswoman for the National Institutes of Health declined to comment in detail, but provided a statement from Dr. Harvey Alter, an author of the still-unpublished study and an N.I.H. infectious-disease expert. He said, “My colleagues and I are conducting additional experiments to ensure that the data are accurate and complete,” adding, “Our goal is not speed, but scientific accuracy.”
Word of the findings from the N.I.H. study spread rapidly last month when a Dutch magazine quoted Dr. Alter as saying that his research team had found a high rate of XMRV infection among patients with chronic fatigue syndrome. Dr. Alter reportedly made the statements at a blood safety meeting in Zagreb, Croatia.
Dr. Randy Schekman, editor in chief of the Proceedings of the National Academy of Sciences, said last week that he expected the matter to be resolved within weeks, although he would not discuss specifics of the study or the journal’s review of it. The journal, he added, had been “inundated by e-mails from people with chronic fatigue syndrome begging us to release this paper.”
The debate over XMRV began last fall, when the journal Science published a study reporting that two-thirds of blood samples from 101 chronic fatigue patients showed evidence of infection with the retrovirus, compared with less than 4 percent of 218 healthy controls.
According to the C.D.C., at least one million Americans are believed to have chronic fatigue syndrome, marked by disordered sleep, cognitive problems, headaches, joint pain and profound exhaustion. The illness has no known cause and has frequently been dismissed by doctors, researchers and the general public as psychosomatic or psychiatric in nature.
Retroviruses, like H.I.V. and XMRV, store their genetic material as RNA but convert it to DNA to replicate within host cells. Since XMRV was first identified four years ago, several studies have linked it to prostate cancer, although other research has failed to find a link. Whether the retrovirus plays a causal role in this or any disease remains unknown.
The emerging research has caught the attention of the blood bank industry. Canada recently began barring people with chronic fatigue syndrome from donating blood because of concerns about possible XMRV transmission. The AABB, formerly known as the American Association of Blood Banks, issued a similar recommendation last month.
A confirmed link between chronic fatigue syndrome and XMRV could spur thousands of patients to demand treatment with antiretroviral medications. Although some drugs used to treat the human immunodeficiency virus have demonstrated XMRV-fighting properties in the lab, they have not been clinically tested for this use.
Nonetheless, Dr. Jamie Deckoff-Jones, a physician in Santa Fe, N.M., has been blogging to an eager audience about the improvements she and her daughter, both given a diagnosis of chronic fatigue syndrome, have experienced while following a regimen of H.I.V. medications.
“I’m taking antiretrovirals in an attempt to save my life,” she explained in an e-mail message. “I don’t have five years to wait around while the scientists and politicians try to figure it out.”
Since the report last year in Science, however, three other published studies, like the new C.D.C. paper, have raised doubts by failing to replicate the findings. The contradictory findings have been attributed to factors like how chronic fatigue cases have been selected and the difficulty in identifying XMRV infection because of a lack of standardized testing protocols.
The Science study was conducted by the Whittemore Peterson Institute for Neuro-Immune Disease, a research center at the University of Nevada, Reno, along with the National Cancer Institute and the Cleveland Clinic. Annette Whittemore, founder and president of the institute, faulted C.D.C. researchers for historically focusing on stress and other psychological factors as major causes of chronic fatigue syndrome, rather than possible infection.
“They’ve been working on chronic fatigue syndrome since the mid-80s, and yet we still don’t have any answers from the C.D.C.,” said Ms. Whittemore, whose daughter has the illness.
Stephan Monroe, director of the C.D.C.’s division of high-consequence pathogens and pathology, said the agency believed that infectious agents could be one of many possible triggers for the disease but that no pathogen had yet emerged as a “primary cause.”
He said he was not surprised by the current uproar among patients. “This is a very well-informed and highly connected patient and advocacy population, and whenever there’s any new information, it’s circulated widely,” he said.
Source: New York Times | | Slow and steady might not win the weight-loss race Thu 15th July 2010 | NEW YORK (Reuters Health) - If you're trying to lose weight and keep it off, new research suggests you take up a diet and exercise plan that will help you lose a big chunk of weight right off the bat.
Some doctors and dieticians think that losing lots of weight fairly quickly makes it more likely that dieters will gain most of it back, and so they often encourage overweight and obese patients to lose weight in small increments.
But scientists have found that no matter how much weight people initially lose, they seem to gain back a similar percentage of that weight over the next year.
"I think there is more of a myth that if people do this very slowly they're going to ultimately be able to lose more weight," Dr. Deborah Tate, a clinical psychologist who studies obesity at The University of North Carolina at Chapel Hill who was not involved with the research, told Reuters Health.
If long-term weight is what you care about, "it should be recommended and favored that people lose a high amount of weight," said Dr. Jeroen Barte, a researcher at the National Institute for Public Health and the Environment in the Netherlands and the lead author of the new research.
Barte and his colleagues presented their findings Monday at the International Congress on Obesity in Stockholm, Sweden. Their study was also published online in Obesity Reviews in March.
The authors analyzed data from 12 different weight-loss studies covering almost 1,000 overweight and obese participants. In all of the studies, participants went through an intensive weight-loss program that gave them exercise and nutrition guidance. The programs lasted between 10 weeks and one and a half years, depending on the study.
Dieters were weighed at the beginning and end of the weight-loss programs, and again at least one year after completing the programs. The authors compared how much of their initial weight loss dieters were able to keep off for those that had lost between 5 and 10 percent of their body weight and those that had lost more than 10 percent.
The average participant started at 209 pounds and lost about 20 pounds over the course of the program. One year later, no matter how much weight they had initially lost, participants had gained back an average of about half that weight.
That meant that the dieters who had initially dropped the most weight also ended up with the best long-term results.
The findings are part of a growing number of studies that show that slow and steady weight loss might not be the way to go, said Tate. The evidence, she said, shows that "We should perhaps be encouraging better initial weight loss."
That doesn't mean that people should be dropping pounds at unsafe levels. One or two pounds per week is still the recommended rate for people trying to lose weight, she confirmed.
The authors say that future studies should follow dieters for longer than one year after their initial weight loss to truly understand the long-term impacts of that initial loss.
But for now, they say, doctors should encourage weight loss of 10 percent or more in their overweight and obese patients if the goal is to have them at their slimmest down the road.
SOURCE: http://link.reuters.com/cud57m Obesity Reviews, online March 24, 2010.
| | Acupuncture fails to boost IVF success in study Wed 14th July 2010 | NEW YORK (Reuters Health) - While some studies have suggested that acupuncture might boost a woman's chances of becoming pregnant through in-vitro fertilization (IVF), new findings question whether there is a true benefit.
In a study of 160 women who underwent IVF at one infertility clinic, researchers found that those who were randomly assigned to have acupuncture right before and after their treatment were no more likely to become pregnant than those who had a "sham" version of acupuncture.
Of women in the acupuncture group, 45 percent were found to be pregnant five to six weeks after their IVF cycle. The rate was 53 percent among those who received the sham procedure.
Acupuncture has been used for more than 2,000 years in Chinese medicine to treat a wide variety of ailments. According to traditional medicine, specific acupuncture points on the skin are connected to internal pathways that conduct energy, or qi ("chee"), and stimulating these points with a fine needle promotes the healthy flow of qi.
IVF involves fertilizing a woman's eggs in a lab dish, then transferring the resulting embryos to her uterus.
Some past studies have found that acupuncture, performed around the time of the embryo transfer, may boost a woman's chances of becoming pregnant. But it was unclear whether that reflected a true effect of acupuncture or some "non-specific" effect of having an additional therapy.
So for the new study, Dr. Irene Moy and colleagues at Northwestern University in Chicago randomly assigned women undergoing IVF at their fertility clinic to one of two treatment groups. In one, women received two sessions of "true" acupuncture, delivered to points that are connected to fertility, according to traditional Chinese medicine; women in the other group received needle stimulation to body sites not used in acupuncture.
In both groups, the sessions were performed right before and after the embryo transfer.
In the end, Moy's team found, women who received the sham acupuncture had a higher pregnancy rate -- though the difference was not significant in statistical terms.
The findings are not the final word on acupuncture and IVF, however, according to Moy and her colleagues.
One possibility, they note, is that acupuncture needling, even performed at non-acupuncture sites, has some sort of effect on IVF pregnancy rates that is outside of the principles of traditional Chinese medicine. If that's the case, effects of the sham acupuncture used in this study might have masked any benefit of the traditional version.
The researchers say that future studies could compare true acupuncture with "placebo" needles that do not penetrate the skin.
They also note that the protocol used in this and other clinical trials -- acupuncture sessions only on the day of the embryo transfer -- may not be adequate. In real-world practice, acupuncturists treating women with fertility problems would typically perform several sessions over weeks or months.
SOURCE: http://link.reuters.com/myx37m Fertility and Sterility, online June 21, 2010.
| | Drug plus counseling boosts weight loss: study Wed 14th July 2010 | NEW YORK (Reuters Health) - An experimental obesity drug, taken along with formal counseling on lifestyle changes, may spur greater weight loss than counseling alone, a new study finds.
The study of nearly 800 obese adults examined the effects of a drug called Contrave -- which combines the antidepressant bupropion (Wellbutrin) and naltrexone, a medication used to treat alcohol and drug addiction.
The trial is one of four studies that the drug's developer, Orexigen Therapeutics, has sponsored in a bid to win approval from the U.S. Food and Drug Administration (FDA).
The other trials have so far shown that Contrave generally outperforms placebo pills in spurring weight loss; in one, for instance, study participants on the drug lost an average of 6 percent of their initial weight over one year, compared with just over 1 percent among placebo users.
The current findings support the previous results, and suggest that combining the medication with counseling on diet and lifestyle would provide further benefits, the researchers report in the journal Obesity.
They found that over one year, participants in the drug-plus-counseling group lost 9 percent of their initial weight, on average -- versus an average of 5 percent among those who received behavioral counseling plus a placebo.
Orexigen recently filed for FDA approval of Contrave and has said that it expects the agency to give a ruling early next year.
The drug is one of three experimental weight-loss medications currently under FDA scrutiny. Later this week, an advisory panel to the agency is set to review Qnexa, a weight-loss drug developed by Vivus Inc. The drug combines phentermine, an appetite suppressant, with topiramate, an epilepsy medication that also happens to help control appetite. In documents made public on Tuesday, FDA staff said Onexa appears to help people shed pounds, but concerns remain about its safety.
The third candidate drug -- lorcaserin, developed by Arena Pharmaceuticals Inc. -- acts on certain receptors in a portion of the brain that regulates appetite and metabolism.
For its part, Contrave is believed |
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