FOOD & HEALTH SKEPTIC ARCHIVE
Monitoring food and health news
-- with particular attention to fads, fallacies and the "obesity" war
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A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
A brief summary of the last 50 years' of research into diet: Everything you can possibly eat or drink is both bad and good for you
31 August, 2008
Trapped inside their bodies, apparently switched off to the world, but still alive: they are the undead. Or so we thought. Forty per cent of patients in a `vegetative state' are misdiagnosed. Now British scientists are leading the field in trying to put that right
Kate Bainbridge is a lively 37-year-old former schoolteacher. We are communicating in the conservatory of her parents' home in south Cambridge. She has expressive eyes and a broad and ready smile, but she can utter only occasional single words with difficulty. She sits in a wheelchair "speaking" with the aid of a letter-board, using her left forefinger to spell out words individually.
Ten years ago, Kate went into a deep coma and was on a ventilator for several weeks. She had suffered severe brain inflammation after contracting a viral infection. When she came out of the coma, she opened her eyes and could breathe naturally, but she was unresponsive to speech and visual stimuli, and appeared to lack all conscious awareness. She was still in this condition four months after falling ill, and was later diagnosed to be in a persistent vegetative state, or PVS: in other words, persistently unaware. But the diagnosis was wrong.
Although Kate could not speak, or hear properly, or make any kind of signal, or take in sustenance except through a tube into the stomach, she was sometimes aware of herself and her surroundings. She had a raging thirst that was not alleviated by the ward staff. She was racked with pain. Sometimes she'd cry out, but the ward staff thought it was just a reflex action. Kate suffered so much pain and despair that she tried to take her own life by holding her breath.
Then a Cambridge neuroscientist called Dr Adrian Owen put her in a special kind of scanner and performed an unprecedented experiment. It revealed evidence of fluctuating levels of brain activation when she was presented with pictures of her parents. From that point, she started her long journey back into the world. This is a story about brain-impaired patients who come gradually out of coma into "minimal awareness" after being misdiagnosed as being in PVS: breathing, appearing to be wakeful, yet deemed to be dead to themselves and the world. It is also about the disastrous consequences of such misdiagnoses, estimated in the UK and other countries to be running at two in five cases. And, crucially, it is about a neuroscientific research programme that is set to transform the prospects of diagnosis, treatment and rehabilitation of brain-injured people the world over.
Only an estimated 20% of patients return, like the Top Gear presenter Richard Hammond after his car crash in September, to fully functioning normality after serious brain injury. The range of disability following brain damage is hugely varied in type and severity. It is not known how many PVS and minimally conscious patients there are in this country, since no central registry exists. It is likely, according to a canvass of many neurology professionals, to be in the tens of thousands. More certain is the grim reality of hospital wards and long-term care homes where the persistently vegetative and the minimally conscious languish, sometimes for decades.
To write this article I have had the sobering experience of witnessing the plight of patients with severely impaired consciousness - the intubations, the double incontinence, the stricken semicircle of wheelchairs parked before the unwatched day-room TV. And I have met the anguished families of those who are denied final grieving and closure for a loved one condemned to what appears a living death. All too often I have spoken to a wife or husband, or mother or father, who will travel anything up to two hours each way by taxi, every day, to spend time with an unresponsive child or spouse.
But here's at least one mordantly amusing and true story told to me by a psychologist at Putney's Royal Hospital for Neuro-disability. "Young man with motorbike head injury in a coma. His mum, a keen evangelical, comes every day with friends to sing Onward, Christian Soldiers by his bedside. She's hoping to stimulate his brain into action. It works: he comes round, but he can't speak. So they fit him up with one of those Stephen Hawking-type laptops, and the first words he speaks are: "For God's sake, Mum, shut it!" That's about as funny as it gets on a brain-injury ward, but there's a serious take-home message. Even minimally aware patients can retain emotions, personality, a capacity to suffer - and, as the young biker showed, attitude.
The biggest, most tragic clinical myth about brain injury today is that PVS can be reliably diagnosed by bedside observation alone. It has in fact been known for at least a decade, ever since a key survey of brain-injured patients, that misdiagnosis of the condition runs at more than 40%, a statistic originally calculated by Professor Keith Andrews, former head of the Putney hospital, and confirmed by recent surveys in Europe and North America. This means that valuable rehabilitation strategies are routinely neglected, and misdiagnosed patients end up on unsuitable wards or in care homes where their needs are neither understood nor met.
Up to 12,000 people under 40 in this country suffer traumatic brain injury every year, and there are serious deficiencies in their rehabilitation, according to Professor John Pickard, head of neurosurgery at Addenbrooke's hospital, Cambridge: "The tendency for patients to be left to languish on general medical, surgical and orthopaedic wards continues to their detriment." The shocking term being used by campaigning neurologists and neurosurgeons is that unknown numbers of patients are being just "warehoused".
Christine Simpson, a mother of two in her mid-fifties, and her husband, Colin, encountered the PVS misdiagnosis phenomenon two years ago. After suffering a brainstem stroke, Christine was first admitted to the intensive-care unit at the Princess Alexandra hospital, Harlow, then transferred to a general respiratory ward, where she remained for about a month.
"I was told that she would probably get a chest infection and not survive more than a few weeks," says Colin. "Even on the respiratory ward I was told she was still in coma, though she was communicating with me at times through her eye movements. Only because myself and our two grown-up sons were constantly at her bedside did she get proper attention. "On one occasion I found her lying flat with a deflated tracheotomy cuff. She was blue in the face and having difficulty breathing."
Other instances of poor care, Colin claims, involved a catheter bag infrequently changed, and a gastric tube not replaced routinely according to clinical guidelines. He also contends that Christine was prematurely discharged from intensive care as a result of the PVS misdiagnosis. His formal petition that the hospital has not done enough to resolve his complaints was upheld by the Healthcare Commission on November 9.
Much more here
PHYSIOGNOMY, the art or science of predicting inward character from outward form, has had its ups and downs over the years. A century ago, the idea that a person's character could be seen in his face was more or less taken as given. It then fell out of favour, along with the idea that behaviour is genetically determined, as Marxist ideas of the pliability and perfectibility of mankind became fashionable. Now, it is undergoing something of a revival. It has been found, for example, that women can predict a man's interest in infant children from his face. Trustworthiness also shows up, as does social dominance. The latest example comes from a paper just published in the Proceedings of the Royal Society by Justin Carre and Cheryl McCormick, of Brock University in Ontario, Canada. This suggests that in men, at least, it is also possible to look at someone's face and read his predisposition to aggression.
The thesis developed by Mr Carre and Dr McCormick is that aggressiveness is predictable from the ratio between the width of a person's face and its height. Their reason for suspecting this is that this ratio differs systematically between men and women (men have wider faces) and that the difference arises during puberty, when sex hormones are reshaping people's bodies. The cause seems to be exposure to testosterone, which is also known to make people aggressive. It seems reasonable, therefore, to predict a correlation between aggression and face shape.
To test their thesis, Mr Carre and Dr McCormick looked at the fine, old Canadian sport of ice hockey. This is, famously, not a gentle game. It is also a game in which the rules provide a plausible proxy for aggressiveness, namely the amount of time a player spends off the ice in the penalty box for such infringements as knocking his opponent's teeth out with a well-aimed stick.
The two researchers obtained photographs of several university and professional ice-hockey teams, and measured the facial ratios of the players. They also obtained those players' penalty records. Just as they expected, the wider a player's face, the more time he spent in the cooler.
Ice hockey, though, is mostly a man's game (women might argue that they are too sensible to get involved, although the Canadian ladies did win a gold medal at the last winter Olympics). To find out whether the theory was true for females as well, Mr Carre and Dr McCormick turned to that stock experimental subject, the university undergraduate. They recruited several dozen of both sexes and got them to play a game against what they thought was a person in another room but was actually a computer. Various measures of aggression taken during this game suggest that men are the same everywhere, be they students or sportsmen. Aggression was not, however, predictable in women students-or, at least, not from the shapes of their faces.
It seems, therefore, that facial ratio in men is a biologically honest signal of aggressiveness. Honest signals are those, such as luxuriantly feathered tails, that cannot be mimicked by individuals who would like the benefits without the costs. In the case of aggressiveness, the benefit to the aggressive individual is, paradoxically, that he will not have to get into fights in order to prove the point. The fear induced by his face should be enough by itself. At least, that is the hypothesis. The experiment to prove it has yet to be done.
30 August, 2008
Britain: Regulating quack medicine makes me feel sick
If alternative remedies are either untested or ineffective, why are we promoting them?
It is fashionable to think things are true for no better reason than you wish it were so. The latest sign of this trend is a report to the Department of Health from Professor Michael Pittilo, Vice-Chancellor of the Robert Gordon University, Aberdeen. His May report - on acupuncture, herbal medicine, traditional Chinese medicine and the like - recommends that these therapies should have statutory regulation run by the Health Professions Council, and that entry for practitioners should "normally be through a bachelor degree with honours". Consultation is supposed to begin around now.
Both of the ideas in the report are disastrous. The first thing you wanted to know about any sort of medical treatment is: "Does it work?" One of the criteria that must be met by groups aspiring to regulation by the HPC is that they "practise based on evidence of efficacy". That evidence does not exist for herbal and Chinese medicine, which remain largely untested. For acupuncture the evidence does exist and it shows very clearly that acupuncture is no more than a theatrical placebo.
Placebos can, it is true, make you feel better; and if there is no better treatment, why not use them? That's fine, but it raises huge ethical questions about how much you can lie to patients, and how much you can lie to students who are training to use the placebos.
New Labour has often said that its policies are guided by the best scientific evidence, but the problem is that the answer you get depends on whom you ask. Pittilo's committee consisted of five acupuncturists, five herbalists and five representatives of traditional Chinese medicine (plus eleven observers). There was not a single scientist or statistician to help in the assessment of evidence. And it shows: the assessment of the evidence in the report was execrable.
Take one example, the use of a herbal preparation, Gingko biloba, for the treatment of dementia. On page 25 of the report we read: "There have been numerous in vitro and in vivo trials on herbal medicine... which have established the benefits of single ingredients such as gingko...for vascular dementia". That is totally out of date. The most prestigious source of reliable summaries of evidence, the Cochrane Collaboration, says: "There is no convincing evidence that Ginkgo biloba is efficacious for dementia and cognitive impairment". The NHS Complementary and Alternative Medicine Specialist Library (compiled by alternative medicine people) says: "The evidence that ginkgo has predictable and clinically significant benefit for people with dementia or cognitive impairment is inconsistent and unconvincing." Since then another large trial, funded by the Alzheimer's Society, concludes: "We found no evidence that a standard dose of high purity Ginkgo biloba confers benefit in mild-moderate dementia over six months."
The Government's answer to the problem is, as always, to set up more expensive quangos to regulate alternative medicine. That might work if the regulation was effective, but experience has shown it isn't. It makes no sense to regulate placebos, especially if you don't admit that is what they are. The Government should be warned by the case of chiropractors about the dangers of granting official recognition before the evidence is available. The General Chiropractic Council already has a status similar to that of the General Medical Council, despite it being based on the quasi-religious idea of "subluxations" that nobody can see or define. Recent research has shown it to be no more effective, and less safe, than conventional treatments that are much cheaper.
The problems that Professor Pittilo's recommendations pose for universities are even worse. You cannot have universities teaching, as science, early 19th-century vitalism, and how sticking needles into (imaginary) meridians rebalances the Qi so the body systems work harmoniously. To advocate that degrades the whole of science.
The vice-chancellors of the 16 or so universities who run such courses presumably do not themselves believe that vitalism is science, or subscribe to the view that "amethysts emit high yin energy", so it is hard to see why they accept taxpayers' money to teach such things. Thankfully, the University of Central Lancashire abandoned its first-year homoeopathy course this week because of low numbers.
Fortunately there is a much simpler, and probably much cheaper, solution than Pittilo's: enforce the laws that already exist. It is already illegal to sell contaminated and poisonous goods to the public. It is already illegal to sell goods that are not as described on the label. And, since May 2008, new European laws make it explicitly illegal to make claims for any sort of treatment when there is no reason to believe the claims are true. At the moment these laws are regularly and openly flouted on every hand. Enforce them and the problem is solved.
BOOK REVIEW of "Trick or Treatment" by Simon Singh and Edzard Ernst
Review by SCOTT GOTTLIEB
When I was practicing medicine in the Elmhurst section of New York about five years ago, my colleagues and I confronted an epidemic of liver damage among the recently arrived Chinese immigrants who live there. We put these patients through an exhaustive battery of tests for conventional sources of hepatitis, the most likely culprit, but found none. The mysterious illness, we decided, must have been caused by the folk therapies, usually herbal, that our patients often used but rarely disclosed to their doctors. There was little we could do but counsel them to stop. Instead of following our professional advice, though, they usually just added new herbs to their regimen, hoping to solve their liver problems but sometimes making themselves even more ill.
The Elmhurst epidemic was a classic example of the clash -- both cultural and scientific -- between "alternative" and conventional medicine. In this case, the inability of doctors to treat a liver ailment strengthened the false faith of patients in other cures. Usually, alternative medicine is a harmless distraction. And some treatments actually do offer benefits. But going outside modern medical practice also carries dangers.
Luckily, hundreds of studies have examined the purported benefits of various alternative-medicine treatments. In "Trick or Treatment," Simon Singh and Dr. Edzard Ernst report on the results. Ginseng has been proposed as a cure-all for everything from cancer to common colds, but there's no evidence that it does any good. Shiatsu massage appears to be a "waste of effort and expense," the authors say. Many aspects of traditional Chinese medicine, like the use of the herbs aristolochia and liquorice, are potentially harmful. Aromatherapy can relieve stress, but there is not a lick of evidence that it can treat a specific illness. Chelation therapy -- a legitimate method of removing heavy metals such as lead or mercury from the body, but now pitched in alternative-medicine circles as a cure for heart disease and other ailments -- is "disproven, expensive, and dangerous," according to Mr. Singh and Dr. Ernst. They urge patients "not to use this treatment."
Some alternative remedies, it should be said, do appear to have value. There is evidence that St. John's Wort can help mild depression, although probably not as well as conventional antidepressants. Echinacea may be able to help relieve symptoms of the common cold, and perhaps reduce the length of illness, but so can many better understood conventional remedies that are sold over the counter. "It seems bizarre," the authors note, in light of the disappointing results, "that alternative treatments are touted as though they offer marvelous benefits."
Dr. Ernst is not a dispassionate observer. He is a pioneer in the field of complementary medicine -- a branch of the medical profession whose practitioners prescribe selective alternative treatments. But he is also a scourge of too-large claims made for his field. Based at the University of Exeter in England, he leads a research group that has spent 15 years studying alternative remedies, trying to separate snake oil from science. Mr. Singh, his co-author, is a science journalist whose books include "Fermat's Enigma" and "Big Bang." Together they conclude, after cataloging the evidence, that most of the popular forms of alternative medicine are "a throwback to the dark ages." Too many alternative practitioners, they say, are "uninterested in determining the safety and efficacy of their interventions."
And safety is a real concern. "Chiropractors who manipulate the neck can cause a stroke . . . some herbs can cause adverse reactions or can interfere with conventional drugs." The authors are particularly hard on homeopathy, the practice of using ultradilute solutions of common substances. The solutions are so dilute, though, that they are often little more than water. "Homeopathic remedies, which of course contain no active ingredient, can be dangerous if they delay or replace a more orthodox treatment," Mr. Singh and Dr. Ernst write, calling homeopathy "the worst therapy encountered so far -- it is an implausible therapy that has failed to prove itself after two centuries and some 200 clinical studies."
"Trick or Treatment" includes a brisk history of our evidence-based approach to medicine, tracing the development of the modern clinical trial from its earliest days, when scurvy was shown to be caused by insufficient vitamin C and bleeding was debunked as a medical cure. Unfortunately, the evidence of clinical trials is largely ignored when it comes to alternative medicine.
So the treatments persist: Americans spend an astonishing $3 billion annually on chiropractors and about $1.5 billion on homeopathy, not to mention billions more for herbal remedies. Government is complicit: Most states mandate health-insurance coverage for chiropractic visits, and many states direct insurers to cover the cost of acupuncture -- another remedy with far fewer benefits than are commonly claimed for it.
Why is there so much blind faith? Mr. Singh and Dr. Ernst blame media hype, celebrities and even certain doctors -- complementary-medicine doctors for shading facts but also, importantly, conventional doctors whose high-handedness breeds patient frustration, opening the door to the seductions of alternative medicine.
"Alternative medicine is not so much about the treatments we discuss in this book," the authors write, "but about the therapeutic relationship. Many alternative practitioners develop an excellent relationship with their patients that helps to maximize the placebo effect of an otherwise useless treatment." To bring all treatments in line with rigorous science, an "excellent relationship" between doctor and patient is a good place to start.
29 August, 2008
Aussie men eating more meat pies
Note for American readers: Most pies sold in Australia contain minced or cubed meat, not fruit. The meat pie is Australia's national food. I LOVE meat pies and eat them frequently -- both for breakfast and for dinner. They are FULL of salt and fat too! Yummy! They are so widely eaten in Australia (together with a lot of other fatty food such as sausage rolls) that they have to get some credit for the long lifespans that Australians characteritically have -- that is if we concede that diet has any effect on lifespans at all
DOWNTRODDEN blokes are biting back and sending meat pie sales soaring. One of Australia's biggest pie maker, Patties, has announced a 10 per cent jump in sales and says fed-up men are fuelling the surge. "Blokes are sick of being told what they can and can't eat," Patties marketing manager Mark Connolly said. "They've had a gutful of it and are going back to living by their own rules. "If they feel like having a pie and a few beers, they'll have a pie and a few beers."
Patties holds over half the Australian market for pies, sausage rolls and pasties. Its brands include Patties, Herbert Adams and the iconic Four'N Twenty range. The Melbourne-based firm reported an 8.6 per cent overall profit rise in the 2007-08 financial year. Pie sales were slightly down the year before, in a fall blamed on unusually hot weather.
The success of its blokiest brand, Four'N Twenty, follows an advertising campaign ridiculing salads. Mr Connolly called meat pies "the nearest thing we've got to a national cuisine". He said strong sales at supermarkets were matched by a 10 per cent jump at sporting venues, despite a constantly growing range of alternatives. "Pies keep selling and selling," Mr Connolly said. "At the end of the day they can't move the more trendy stuff."
Road worker Grant Dye said there was nothing better than a hot pie on a cold day. "A good meat pie is chunky and nice and tender," Mr Dye said. "It doesn't worry me what brand it is as long as it's nice and fresh."
Spotless, which caters for the Melbourne Cricket Ground, said pies were only one of a broad range of food options now, but remained a staple seller. Any growth in sales would reflect the growth in attendances, a spokeswoman said. "There are more people going to venues and more events held at the MCG. "If it is due to anything, it would be due to the increased patronage."
But Mr Connolly said tradition and tighter economic times were also factors. But it was more about manpower. "They're not that complicated. They just want to be left to their own devices," Mr Connolly said.
High cholesterol levels drop naturally in children on high-fat anti-seizure diet
Another confirmation of the unimportance of diet to serum cholesterol
Elevated cholesterol levels return to normal or near normal levels over time in four out of 10 children with uncontrollable epilepsy treated with the high-fat ketogenic diet, according to results of a Johns Hopkins Children's Center study reported in the Journal of Child Neurology. The study appears online ahead of print here.
In the four-year study, the Hopkins Children's team followed 121 epileptic children with intractable seizures on the high-fat, low-carbohydrate ketogenic diet designed to control such seizures. While most children developed high cholesterol after starting the diet, cholesterol gradually improved in nearly half of them, returning to normal or near-normal levels, with or without modifications to their diet to reduce fat intake.
In fact, researchers point out, diet modifications-including reducing total fat content or certain types of fats called saturated fats and adding nutritional supplements-reduced high cholesterol just as much as doing nothing. High cholesterol is defined as total cholesterol greater than 200 mg per deciliter of blood, bad or LDL (low-density lipoprotein) cholesterol greater than 130, triglycerides greater than 130, and good or HDL (high-density lipoprotein) lower than 35.
Researchers prescribed dietary modifications to increase "good," polyunsaturated fats in the diets of 15 children with elevated cholesterol. Dietary modifications decreased cholesterol by 20 percent in 9 out of the 15 (60 percent) children whose diets were modified. Surprisingly, cholesterol also dropped by at least 20 percent in 41 percent of the 37 children whose diets remained unchanged. The findings, while encouraging overall, also mean that relying on diet changes alone may not do much for those children in whom cholesterol remains persistently elevated, and that new approaches for these patients are needed, researchers say.
The findings should come as comforting news to pediatric neurologists, general pediatricians and parents of children treated with the ketogenic diet, and reassure them that, in most patients, increases in cholesterol may be short-lived, researchers say. Previous long-term studies by the Hopkins group of children who were on the diet between six and 12 years echoed these findings. The ketogenic diet, believed to work by triggering biochemical changes that eliminate seizure-provoking short-circuits in the brain's signaling system, is used in many children with hard-to-control epilepsy and in those whose seizures do not respond to traditional anticonvulsant medications.
"We are greatly encouraged by our findings because the nearly half of the children on the diet were either able to maintain healthy cholesterol or gradually metabolized the extra fat and returned to somewhat normal cholesterol levels," says senior investigator Eric Kossoff, M.D., a pediatric neurologist at Hopkins Children's. "This means the benefits of the diet-a diet that is lifesaving in many children and therapeutic in most of them-continue to outweigh the risks."
Noting that 40 percent of children maintained normal cholesterol even after starting the diet, researchers found that children fed a formula-based, liquid-only ketogenic diet were nearly three times less likely to develop high cholesterol. Researches attribute this finding to the nearly zero fat content in commonly used ketogenic diet formulas.
In the group with normal cholesterol, 78 percent of children (31 out of 40) were fed formula-based ketogenic diet. This finding, while requiring further study, points to another possible treatment for high cholesterol, Kossoff says, by switching children with persistently elevated cholesterol to formula-based ketogenic diets at least some of the time. The formula-based ketogenic diet contains only one-third the amount of saturated fats-the worst kind in terms of cholesterol-of the solid food version of the ketogenic diet. Because doctors can tweak the ratio of fat vs. carbohydrates depending on each child's severity of seizures, the investigators examined whether higher-fat versions of the ketogenic diet raised cholesterol additionally, but found that higher-fat ratio did not make cholesterol worse than a lower-fat ratio.
Some of the other findings:
One-fourth of 121 children had elevated total cholesterol before starting the diet, which increased to 60 percent (59 out of 99 children at follow-up) after the initiation of the diet.
18 percent (22 out of 119) had triglycerides over 130 before the diet, which increased to 51 percent (49 out of 96) after starting the diet.
19 percent (21 out 110) had bad cholesterol over 130 before the diet, which increased to 53 percent (48 out of 93) after starting the diet.
28 August, 2008
Study suggests low-level arsenic exposure may be linked with Type 2 diabetes
Some reasonable caution in this report. Just a small personal note: As a result of past medical "wisdom", I am full of arsenic and yet I test out fine on diabetes tests.
A new analysis of government data is the first to link low-level arsenic exposure, possibly from drinking water, with Type 2 diabetes, researchers say. The study's limitations make more research necessary. And public water systems were on their way to meeting tougher U.S. arsenic standards as the data were collected. Still, the analysis of 788 adults' medical tests found a nearly fourfold increase in the risk of diabetes in people with low arsenic concentrations in their urine compared to people with even lower levels.
Previous research outside the United States has linked high levels of arsenic in drinking water with diabetes. It's the link at low levels that's new. The findings appear in Wednesday's Journal of the American Medical Association. "The good news is, this is preventable," said lead author Dr. Ana Navas-Acien of Johns Hopkins Bloomberg School of Public Health in Baltimore.
New safe drinking water standards may be needed if the findings are duplicated in future studies, Navas-Acien said. She said they've begun a new study of 4,000 people. Arsenic can get into drinking water naturally when minerals dissolve. It is also an industrial pollutant from coal burning and copper smelting. Utilities use filtration systems to get it out of drinking water.
Seafood also contains nontoxic organic arsenic. The researchers adjusted their analysis for signs of seafood intake and found that people with Type 2 diabetes had 26 percent higher inorganic arsenic levels than people without Type 2 diabetes. How arsenic could contribute to diabetes is unknown, but prior studies have found impaired insulin secretion in pancreas cells treated with an arsenic compound.
The policy implications of the new findings are unclear, said Molly Kile, an environmental health research scientist at the Harvard School of Public Health. Kile wrote an accompanying editorial in the journal. "Urinary arsenic reflects exposures from all routes - air, water and food - which makes it difficult to track the actual source of arsenic exposure let alone use the results from this study to establish drinking water standards," Kile said.
Also, the findings raise a chicken-and-egg problem, she said, since it's unknown whether diabetes changes the way people metabolize arsenic. It's possible that people with diabetes excrete more arsenic. The United States lowered arsenic standards for public water systems to 10 parts per billion in 2001 because of known cancer risks. Compliance was required by 2006, years after the study data were collected in 2003 and 2004.
Are You Sure You Want Fries With That?
Mandatory calorie counts cross the line between informing and nagging
In a 2007 survey of California voters, 84 percent said they thought the government should force restaurant chains to display calorie numbers on their menus and menu boards. That may happen soon: The state Assembly is considering a bill, already approved by the state Senate, that would make California the first state to impose such a menu mandate.
Yet the desires that people express in polls are often at odds with the preferences they reveal in the marketplace. The restaurant business is highly competitive. If customers really were clamoring for conspicuous calorie counts, restaurants would provide them voluntarily. A legal requirement is necessary not because consumers want impossible-to-ignore nutritional information but because, by and large, they don't.
Since they overestimate the demand for nutritional information, advocates of menu mandates also overestimate the impact of making it more visible. "Menu board labeling has the potential to dramatically alter the trajectory of the obesity epidemic in California," the California Center for Public Health Advocacy claims, projecting a weight loss of nearly three pounds a year per fast food consumer. The New York City Department of Health and Mental Hygiene, which began enforcing a calorie count requirement last month, predicts it will stop 150,000 people from becoming obese and prevent 30,000 cases of diabetes during the next five years.
Both estimates are based on a study conducted by New York's health department before the city's menu rule took effect. The researchers asked about 7,300 customers at fast food restaurants in the city whether they had seen and made use of nutritional information, which is typically displayed on posters, brochures, tray liners, or counter mats (as well as on the chains' websites). They also examined the customers' receipts so they could calculate the calorie content of the food they purchased.
The only chain where a substantial share of customers said they noticed nutritional information was Subway, where 32 percent reported seeing it, compared to 4 percent at the other chains. Since Subway promotes a subset of its menu as lower in calories and fat than its competitors' offerings, using a pitchman who lost hundreds of pounds while eating at the chain every day, this disparity is not surprising.
But even at Subway, calorie information seemed to make a difference for just one in eight customers. Of those who reported seeing the calorie information at Subway, 37 percent-12 percent of all Subway customers-said it affected their purchases. Subway customers who said they used calorie information bought about 100 fewer calories than those who said they didn't see it and those who said they saw it but didn't use it.
Notably, "there was no significant difference in mean calories purchased by patrons reporting seeing but not using calorie information and patrons who reported not seeing calorie information." In other words, simply making people aware of calorie content is not enough to affect their food choices.
The information's influence may be limited to people who are predisposed to count calories. If so, the impact of menu mandates will depend on the extent to which those people are not taking advantage of less obtrusive nutritional information already provided by restaurants.
The importance of pre-existing preferences also suggests that it's risky to extrapolate from Subway customers (who, given the chain's marketing, are probably especially weight-conscious) to fast food consumers in general. Another unresolved question is whether people compensate for fewer calories consumed at McDonald's or KFC by eating more at home or elsewhere.
Even if menu regulations don't make any difference on balance, Yale obesity researcher Kelly Brownell recently told the Los Angeles Times, "there's still the issue of the consumer's right to know." What about the consumer's right not to know? The same research that supporters of menu mandates like to cite indicates that most consumers prefer to avoid calorie counts, enjoying their food in blissful ignorance. There's a difference between informing people and nagging them.
Wonders of the human immune system: Blood of survivors of 1918 flu still protects against disease
Nearly a century after history's most lethal flu faded away, survivors' bloodstreams still carry super-potent protection against the 1918 virus, demonstrating the remarkable durability of the human immune system. Scientists tested the blood of 32 people aged 92 to 102 who were exposed to the 1918 pandemic flu and found antibodies that still roam the body looking to strangle the old flu strain. Researchers manipulated those antibodies into a vaccine and found that it kept alive all the mice they had injected with the killer flu, according to a study published online Sunday in the journal Nature.
There's no pressing need for a 1918 flu vaccine because the virus has long since mutated out of its deadly form and is extremely unlikely to be a threat anymore, experts said. What's more important in this research, they said, is that it confirms theories that our immune system has a steel-trap memory. "It's incredible. The Lord has blessed us with antibodies our whole lifetime," said study co-author Dr. Eric Altschuler at the University of Medicine and Dentistry in New Jersey. "What doesn't kill you, makes you stronger."
This is the longest that specific disease-fighting cells have lasted in people, said study lead author Dr. James Crowe, a professor of microbiology and immunology at Vanderbilt University Medical Center in Nashville, Tenn. But these antibodies don't just survive; they have mutated tremendously and now bind tighter to disease cells than other antibodies. That makes them more potent, he said.
Crowe said he hopes to use similar techniques to boost the potencies of vaccines that would be more useful now against newer bird flu strains that could become epidemics.
The 1918 flu killed about 50 million people worldwide and nearly everybody else was exposed to the virus, Crowe said. The specific 1918 virus was lost to the world for decades, until it was reconstructed about three years ago using genetic material from victims. When scientists tested the antibodies from survivors on infected mice, they did so in a high level biosecurity lab at the Centers for Disease Control and Prevention in Atlanta.
The idea for the new study came from an old TV show, said Altschuler. In an episode of the since-cancelled TV series "Medical Investigation," a town improbably gets infected with the 1918 flu and the doctors treat everyone with the reluctantly donated blood of an old butler who survived the original pandemic, he said.
That prompted Altschuler, a professor of rehabilitation medicine who doesn't normally study flu, to look into the idea of testing people more than 90 years old for antibodies. The National Institutes of Health, which paid for much of the study, connected Altschuler with experts in the field and he found the elderly antibody donors.
The findings make sense, said Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases in Bethesda, Md., who wasn't involved with the study. Recent studies have estimated that the human immune system should last many decades, but this gives real proof, he said. "This is the mother of all immunological memory here," Fauci said.
27 August, 2008
Caesarean babies at risk of diabetes
The usual arrogance about assigning direction of causation below. That babies delivered by Caesarian are on average more sickly to start with is completely ignored. Fetal distress is a common reason for Caesarians
Babies delivered by Caesarean section have a significantly higher risk of developing diabetes in childhood than those born naturally, a study suggests. A review of 20 studies on children with type 1 diabetes found those delivered by Caesarean section had a 20 per cent increased risk of developing the condition. The rise in the number of children suffering from type 1 diabetes may be explained by the high rates of the procedure, the researchers say.
The finding adds to the body of evidence about the risks of Caesareans, which now account for nearly 25 per cent of deliveries in Britain. The rate recommended by the World Health Organisation is 10 to 15 per cent.
Jane Jimenez, 33, of Woodford Green, northeast London, had her daughter Lauren, now 5, by Caesarean section after struggling to give birth naturally. As a community paediatric nurse, Mrs Jimenez was quick to spot the first signs of type 1 diabetes. She was cautious about concluding that her daughter's condition was down to her delivery alone, "but perhaps that increased the chances", she said.
There is a strong genetic component to developing diabetes - as well as other known risk factors - but the link between delivery method and diabetes persisted even when these factors were taken into account. It is believed that exposure to bacteria during natural childbirth is key to the development of a child's immune system and that without such exposure a baby may be predisposed to illness - such as diabetes.
Living alone bad for you?
Hard to know what to make of the article below. In the absence of references to any specific research it is no more than an expression of opinion. That poor health may CAUSE isolation rather than isolation causing poor health seems not to be considered. Routine stupidity
RECENT research has discovered that living in isolation may be more destructive to your physical well-being than smoking cigarettes. Statistics proving that people who co-habit with others live longer than those who are alone have been around for several decades.
But the latest research takes this a step further. This doesn't mean that if you are happily enjoying the single life you're going to die prematurely, but it does make you think about life and love a little differently. Those who have survived conflict-laden relationships may well find it easier to take care of just themselves, and perhaps their children or pets. Dealing with another person's vicissitudes can be exhausting, especially if that individual gives you a hard time in the process.
However, if you enjoy sharing your life and bed with someone but also require your space, you need to get creative and discover some of the many ways to maintain your individuality and sanity while having a close relationship with another adult. Many couples not living together take nights off, where they have established safe boundaries that allow them to have their own time without making their partner feel insecure. Usually a phone call before the night off, followed by a catch-up conversation ("Did you sleep well?"), is enough to maintain a good connection.
If the person you love withdraws on a regular basis, and you have to go hunting for him or her, it could be time for a deep conversation. Those who sequester themselves away from even their closest loved ones may also be dealing with depression and/or anxiety. Somehow there's an illusion that being alone makes it all better.
Not everyone who chooses to be alone has a mood disorder, but if you are feeling a little blue you should get yourself checked out by a professional. Being disconnected from the rest of the human race may make you feel safe or empowered, but it's only temporary. We are social beings, and life is much more meaningful when you have someone to share it with
Birth control pill a miracle cure-all?
Drospirenone is a synthetic progestin with an action similar to the natural progesterone so the article below is a bit overblown. It does however seem to be an incremental improvement over other formulations
A new type of contraceptive pill that treats premenstrual tension as well as acne and weight gain will be available in Australia next week. The low-dose pill called YAZ will also reduce the length of a woman's monthly period. The hormone drospirenone used in the pill and a new regimen which has women using sugar pills for just four instead of seven days in their monthly cycle is the secret.
It is the first and only pill to be approved to treat a severe form of premenstrual tension called premenstrual dysphoric disorder (PMDD). Symptoms include pain, mood swings, depression and anxiety and decreased interest in daily activities.
Sydney gynaecologist Gabrielle Casper said the pill will also help women who have less severe premenstrual stress. "These are women who feel a little sad or anxious and the next day they get their period," Dr Casper said. She said the new pill is low dose, using just 20 micrograms of the oestrogen hormone compared to 30, 35 or 50 in many others on the market.
The hormone in it has a mild diuretic effect, preventing bloating and fluid retention. It also makes it less likely the testosterone in a woman's system will affect their skin, Dr Casper said.
Sexual Health and Family Planning Australia spokeswoman Dr Christine Read said the regimen, where women take 24 active pills instead of the usual 21, is what helps with premenstrual tension.
26 August, 2008
Polygamists live longer
The usual stupid causal inferences. That you might have to start out more robust in various ways to acquire and keep plural wives seems not to be considered. And the data have to be suspect anyway. All the really long-lived nations (Such as Australia, Japan and Finland) practice monogamy
Men with more than one wife live longer, a new study of longevity has found. Research published in New Scientist magazine found that polygamy may be the key to a long life, with men from polygamous cultures living 12 per cent longer those from monogamous ones.
A team from the University of Sheffield in the UK came to the conclusion after studying older men from 140 countries that practise polygamy to varying degrees and those from 49 mostly monogamous nations. The lead researcher, ecologist Virpi Lummaa, said the explanation could be both social and genetic. Men who continued fathering kids into their 60s and 70s could take better care of their bodies because they had mouths to feed, Dr Lummaa said.
But evolutionary forces acting over thousands of years could also account for longer-lived men in polygamous cultures, a conference in New York was told.
Articles in Prominent Medical Journal Doubt Worth and Benefit of HPV Vaccines
Note that there have been some pressures to make use of these vaccines compulsory for young girls (e.g. here). More "wisdom" from the health Fascists
The New England Journal of Medicine posted two articles this week that asked why two human papillomavirus vaccines have been so widely distributed given their unproven effectiveness and high costs. Gardasil by Merck Sharp & Dohme, which has already received tremendous criticism for the severe and fatal side-effects experienced by users, and Cervarix by GlaxoSmithKline were the two drugs called to question.
As reported by the New York Times, Dr. Charlotte J. Haug, editor of The Journal of the Norwegian Medical Association, whose editorial appeared in Thursday's issue of The New England Journal, said, "Despite great expectations and promising results of clinical trials, we still lack sufficient evidence of an effective vaccine against cervical cancer. With so many essential questions still unanswered, there is good reason to be cautious."
Both vaccines were tested for relatively short periods of time, revealed Dr. Haug, and researchers are yet to prove whether or not the vaccines offer lasting immunity and if a user's natural immunity to other strains not eliminated by the vaccines will be compromised. Dr. Haug said it is not certain if the protection offered by the vaccines will even lead to reduced rates of cervical cancer.
Jane J. Kim and Dr. Sue Goldie of Harvard, who likewise had a study published in this week's issue of the medical journal, also brought up the fact that the vaccines have not been proven to offer life-long protection. They said that until this is certain, the cost of the vaccines cannot be justified.
Furthermore, the costs of the vaccines cannot be offset by eliminating Pap smear screening because the test is still needed to identify HPV strands that the vaccines do not protect against.
These studies criticizing the effectiveness and cost of the HPV vaccines could not come at worse time for Merck - the drug giant is under fire because of a reported 9,749 cases of severe side-effects and 21 deaths associated with Gardasil.
Why Safe Kids Are Becoming Fat Kids
Just when we thought playgrounds were accident-proof -- no more merry-go-rounds, high slides, jungle gyms, seesaws or pretty much anything that's fun -- it turns out that safety itself can be dangerous. A recent heat wave in New York exposed a new playground risk: The ubiquitous rubber safety matting gets hot, not as hot as McDonald's coffee, but hot enough to scald tender feet. The outrage was immediate. "Playgrounds should be designed with canopies," one park- safety advocate declared. "How many burn cases will it take," Betsy Gotbaum, the city's public advocate asked, "before the city wakes up and acts?"
The headlong drive for safety has indeed created dangers, but not those identified by the safety zealots. Risk is important in child development. Allowing children to test their limits in unstructured play, according to the American Association of Pediatrics, "develop[s] their imagination, dexterity, and physical, cognitive, and emotional strength." Scrapes and bruises are how children learn their limits, and the need to take personal responsibility.
The harmful effects of our national safety obsession ripple outward into society. One in six children in America is obese, and many of them will face a lifetime of chronic illness. According to the Center for Disease Control, this problem would basically cure itself if children engaged in the informal outdoor activities that used to be normal. But how do we lure children off the sofa? One key attraction is risk.
Risk is fun, at least the moderate risks that were common in prior generations. An informal survey of children by the University of Toronto's Institute of Child Studies found that "merry-go-rounds . . . anecdotally the most hated piece of playground equipment in hospital emergency rooms -- topped the list of most desired bits of playground equipment." Those of us of a certain age can remember sprinting to get the contraption really moving. That was fun. And a lot of exercise.
America unfortunately is going in the opposite direction. There is nothing left in playgrounds that would attract the interest of a child over the age of four. Exercise in schools is carefully programmed, when it exists at all. Some schools have banned tag. Broward County, Fla., banned running at recess. (How else can we guard against a child falling down?) Little Leagues forbid sliding into base. Some towns ban sledding. High diving boards are history, and it's only a matter of time before all diving boards disappear.
Safety is meaningful only in the context of other benefits and risks. Safety always involves trade-offs -- of opportunities, of scarce resources and, especially in the case of children's play, of learning to manage risk. The question is whether the trade-off makes sense. Soft rubber matting will cushion any fall. This is probably a good thing, at least in situations where children may fall on their heads. But rubber matting also gets hot.
There's only one solution. Someone on behalf of society must be authorized to make these choices. Courts must honor those decisions. Otherwise, the pious accusations of safety fanatics, empowered by the nearly universal fear of being sued, will guarantee a cultural spiral downwards toward the lowest common denominator. For America's children today, that means spending more than six hours per day staring at a screen. Is that the way we want our children to grow up?
"A little common sense goes a long way," observed Adrian Benepe, New York City's parks commissioner. "Children should wear shoes. They're foolproof protection against hot surfaces." Shoes have undeniable virtues in an urban setting -- a small but useful lesson for young children.
I have an additional idea as well. Why not replant a few of the trees that were cut down, or radically pruned, in an effort to create a controlled play environment? The shade from the trees would keep the rubber matting a little cooler. Who knows, maybe we would even allow children to climb them.
25 August, 2008
Australian teens' risky drinking "linked to" infertility
But not shown to CAUSE infertility -- as Queensland's Nick Martin points out -- deflating a finger-wagging American puritan
Heavy drinking by females in their teens and 20s may reduce their chances of motherhood later in life, new research has found. Previous studies have linked teenage drinking with risky sex and early motherhood. Now a study of Australian twins has shown that alcoholism in women resulted in later childbearing. The study by Washington University's school of medicine analysed the drinking habits and reproductive histories of two groups of Australian twins, born before and after 1964.
Researchers found female alcoholics in both groups had children later in life - a trend not repeated in male alcoholics in the groups. In the first group, comprising people born before 1964, 64per cent of female alcoholics had children compared with 78per cent of other women. In the second group, 38per cent of alcohol-dependent women had children, compared with 49per cent of other women. The study confirmed increasing alcoholism in women. Only 4per cent of women met the criteria for alcohol-dependency in the group born before 1964, compared with 15per cent for the group born after. The study did not consider what amount of alcohol consumption affected fertility.
Lead researcher Mary Waldron, of Washington University, said the study, to be published in Alcoholism: Clinical And Experimental Research in November, served as a warning against excessive alcohol consumption. Previous research examined risks to teens or adults but not both, Professor Waldron said. "Our findings highlight a risk associated with [alcohol dependence] in women that is not widely recognised - a risk that has assumed increasing importance given the increased rates of alcohol misuse by women, and particularly young women. "Young women who drink alcohol may want to consider the longer-term consequences for later childbearing. "If drinking continues or increases to levels of problem use, their ability and opportunity to have children may be impaired."
Nick Martin, a professor at Queensland Institute of Medical Research who took part in the study, said the links between alcohol and fertility were not conclusive. "This was about women with persistent drinking problems," Professor Martin said. "The observation is that they will have less reproduction and delayed reproduction. "While the affect may be hormonal, women with alcohol-dependency probably don't make good partners - that's another possible explanation. I think we have to consider the direct behavioural consequences of alcohol too."
Medical experts expose ADHD misdiagnoses
Two of Australia's most senior medical experts have blown the whistle on the misdiagnosis of ADHD, with at least one in three children wrongly diagnosed with the condition.
The alarming figure comes as a leading psychologist warned there was no evidence of the long-term benefits of medication such as Ritalin. Dr Jon Jureidini told The Daily Telegraph yesterday that the misdiagnosis figure could even be higher, with some children with learning difficulties wrongly prescribed drugs for Attention Deficit Hyperactive Disorder. Dr Jureidini is among a group of experts who have made powerful submissions to the Federal Government's ADHD review panel, which will rewrite guidelines for the diagnosis of the condition.
His warning comes at the same time as a push to ban GPs from diagnosing attention deficit hyperactivity disorder. Some child education experts are concerned doctors are "too readily" labelling children with ADHD and prescribing Ritalin, potentially putting them at risk of dangerous side effects. In their submission, a group of 14 academics has called for multi-disciplinary teams of psychologists, doctors and experts to replace GPs and have sole responsibility for diagnosing the condition. The influential group, from seven universities, including the University of Sydney and the University of Wollongong, has also urged the Federal Government not to declare ADHD a "disability" and allocate special funding for schools based on the number of students suffering it.
A similar move in the US led to an explosion of 600 per cent in the diagnosis, or misdiagnosis, of ADHD as schools competed for the extra grants, the group said. "It is a diagnosis that should not be used in anything other than a tiny fraction of cases in which it is made," Dr Jureidini, head of the Department of Psychological Medicine at Adelaide's Women's and Children's Hospital, said.
The Royal Australasian College of Physicians, which is reviewing the outdated guidelines at the request of the National Health and Medical Research Council, has been accused of taking too narrow a view. Dr Jureidini said that about 30 per cent of boys and girls diagnosed with ADHD do not even meet the current diagnostic criteria, which includes being inattentive and easily distracted. He said up to 90 per cent of those diagnosed would be better off with other treatment.
Two of the RACP's controversial draft recommendations include education programs for teachers on dealing with ADHD pupils and special funding for schools with ADHD students. The group of academics said this would mean children with significant disabilities, including cerebral palsy and autism, would miss out on funding and teaching time.
One of the group, Trevor Parmenter, foundation professor in developmental disability studies in the faculties of education and medicine at Sydney University, said ADHD was too complex to be diagnosed in a GP's office. "It is a very complex issue that goes beyond the symptomology," he said. "If a child has been diagnosed with ADHD, a teacher may think they should be put in a special class. They could be disadvantaged." He said too many children were being diagnosed with ADHD by lazy doctors who did not properly investigate the child's problems.
Why I refused to let my child be weighed
The British government's fat-headed policy on obesity should be boycotted
It appears my wife and I have upset the Government, as part of the small minority of parents who refused to have our 11-year-old child weighed and measured in school last term. The authorities worry that it was the parents of fat children who opted out. Or it could have been parents like us, who object to being conscripted into a fat-headed crusade against child obesity that is heavy on political intrusion and light on proven effectiveness.
Letters are to be sent to parents whose children were weighed, giving a "mark" ranging from "underweight" through "healthy weight" to "very overweight". There has been a predictable PC-gone-mad reaction to the Department of Health's predictably stupid decision to drop the word "obese". But whatever words they use, the message is clear: that the authorities have the right to decide whether or not our children are living "healthy lives". They want to measure not only body mass but moral worth, to decide whether our children fit the State's model. The most likely results will be to produce miserable kids and anxious parents.
Despite overegged talk of a child obesity "epidemic", the real extent, causes and health consequences of children being overweight remain uncertain. What is more certain is the lack of hard evidence that campaigns of intervention in school or family life have any beneficial effects. But whatever the intentions, they do single out kids for more pressure, harassment and ridicule - which is all that our body-conscious pre-teens need.
Yet the authorities throw their substantial weight behind every stunt from policing lunchboxes to weighing children like little piggies. At a time when governments have lowered horizons from creating the Good Society to moulding the Healthy Citizen, the anti-obesity crusade legitimises public monitoring of private behaviour. Ours is an age when bullies can no longer call children fatty in the playground. Yet it is deemed legitimate for government to bully them and their parents, using obesity as a bogeyman in scary stories about how we are killing our kids.
It will be a joyless world for children if we turn the pleasures of food, drink and play into problems of "healthy living". At the Museum of London yesterday, my daughters learnt about the statue Fat Boy of Pie Corner, erected where the Great Fire of 1666 ended to warn Londoners that it was caused by "the sin of gluttony". Today the pious warn us about our unhealthy lifestyles rather than our sins. Back home, the children borrowed a neighbour's Wii Fit game. The first thing it does is decide whether you are ideal, overweight or obese. What fun!
24 August, 2008
Australia: Couple flee to avoid compulsory medical treatment
Another case of DOCS (child welfare agency) harassing good parents over minor infractions while ignoring feral parents. Decent people are a lot easier to deal with, you see.
And the record of compulsory medical treatment is not at all good. The medical wisdom of today is often the iatrogenic disaster of tomorrow. Take the example of compulsory blood transfusions for Jehovah's Witnesses. It was eventually discovered that JWs had a higher survival rate WITHOUT transfusions than did people who got transfusions. As a result, use of transfusions is now much more guarded than it once was.
Fear of vaccines is widespread and objections to it should be regarded as a basic civil liberty in my view. How would YOU like people coming and injecting into you something you did not want? I myself know of no proven harm done by vaccines but people should be allowed to make up their own minds in such a contested area. I have myself had Hep B vaccinations
A Sydney couple are in hiding after the Department of Community Services (DoCS) took out a court order to have their three-day-old boy vaccinated against hepatitis B. The parents, from Croydon Park, fled their home on Thursday to avoid police and DoCS officers after refusing to have their son vaccinated at Royal Prince Alfred Hospital. They told Fairfax newspapers they believe aluminium in the vaccine can cause him more damage than contracting the disease.
The infant's mother, who is from China, was diagnosed with hepatitis B several years ago, but both parents believe the illness, which can cause liver cancer and cirrhosis, can be managed more effectively than any potential neurological damage from the vaccine.
Vaccinations are not compulsory in Australia but it is NSW Health policy that babies born to hepatitis-B mothers are given the immunoglobulin within 12 hours of birth. The treatment is followed up with four more doses of the vaccine over six months.
The father, a financial adviser, is seeking an injunction against the court order. He told Fairfax doctors and midwives on the post-natal ward told him he and his wife would be arrested and they would lose custody of their child if he left the hospital without being vaccinated.
The Supreme Court order, obtained by DoCS, states the baby must be vaccinated by midnight on Thursday but the father is adamant they will stay on the run indefinitely.
Australia: Crooked medical journal
Refuses to print urgent warning to save embarassing medical bureaucrats
A taxpayer-funded medical journal has been accused of suppressing criticisms of flaws in patient medicine handouts that could have fatal consequences for thousands of Australians. The criticisms in a paper by five medical specialists reveal that alleged problems with the official advice for the drugs Cortate and Hysone are still unresolved, more than a year after the concerns were first publicised.
In the case of Cortate -- like Hysone an essential treatment for people with Addison's disease and some other hormonal conditions -- the consumer medicine information (CMI) handouts still advise patients not to take the drug if they have an uncontrolled infection. The paper by the five specialists says this is "dangerously incorrect" and patients taking the drug in fact need to double or even treble their dose to avoid serious illness. "If followed, such advice could lead to life-threatening consequences within 24-36 hours for some thousands of Australians who depend on glucocorticoid replacement," the paper says.
But the journal Australian Prescriber, part of the government-funded National Prescribing Service, faces claims it "nobbled" attempts to alert medical experts to the issue "to avoid a few red faces in Canberra", after it refused to publish the paper. The journal and its editor, John Dowden, may also face accusations they breached internationally accepted publishing procedures, by allegedly sending the five experts' paper to the Therapeutic Goods Administration for comment before the journal had decided whether to accept it. The TGA not only has ultimate responsibility to ensure CMI leaflets are accurate, it is entirely funded by fees charged to drug manufacturers.
In its response to Australian Prescriber, the TGA's national manager Rohan Hammett said a "careful review" of the CMI should allay any concerns over misinformation. The advice in Cortate's CMI regarding infections was not misleading, Dr Hammett said, because this appeared beneath a sub-heading "Before you take Cortate" -- which Dr Hammett said indicated it was only relevant to patients starting the drug, not those already on it.
The lead author of the rejected paper, Jim Stockigt -- a professor of medicine at Monash University -- said the approach of Australian Prescriber had been "amazing", and the journal had "fought tooth and nail to prevent dissemination" of concerns. "It's my feeling that this submission may have been suppressed or nobbled to avoid a few red faces in Canberra and to preserve the impression that all is well with Australian pharmaceutical product and consumer medicine information," Professor Stockigt said. "For those who depend on adrenal replacement for their survival, it is simply dangerous nonsense for the advice 'Do not take Cortate if you have an uncontrolled infection' to remain on the books."
In a letter to Professor Stockigt, Dr Dowden said the paper had been rejected because it was referring to letters printed in other publications a year earlier, it was not related to an article in Australian Prescriber, it was too long, allegations were included in the paper and an "external review did not support all the interpretations made in the correspondence".
After the paper's rejection Professor Stockigt consulted the British-based Committee on Publication Ethics for its views on Australian Prescriber's actions. The COPE's chairman, Harvey Marcovitch, replied that Australian Prescriber had either breached confidentiality by sending the paper to the TGA or, alternatively, the journal had "breached fundamental rules on the potential conflict of interest of reviewers".
A spokesman for Australian Prescriber said the journal had "robust and ethical editorial processes". "The decision not to publish in this case was made by the editorial executive committee and a full explanation was given to the authors," the spokesman said. "The committee stands by this decision."
Cholesterol drug linked to cancer deaths
A cholesterol lowering drug may increase the risk of cancer, according to new findings. The drug called Inegy is taken by thousands of people in the UK and the drug regulator is studying research which has linked to indicated a link to increased cancers and deaths from cancer. It is a combination of the statin simvastatin and ezetimibe for use in patients whose cholesterol cannot be controlled by one drug alone. Just under 300,000 prescriptions were dispensed for Inergy in the last two years in England and Wales, official figures show.
The American Food and Drug Administration issued a statement saying preliminary findings from a study has shown found the drug did not reduce cardiovascular problems as expected and a larger percentage of patients on the drug were diagnosed with and died from all types of cancer than those on the placebo during the five year study.
The FDA did not say how big the alleged increased risk of cancer was and said is not advising that patients should come off the drug nor that doctors should stop prescribing it. Its statement said other trials have shown no increased risk of cancer in patients using the drug. The final report from the trial should be available to the FDA in three months and it expects the analysis to take further six months after that.
A spokesman for the Medicines and Healthcare Products Regulatory Agency in the UK, said: "The MHRA is aware of the issue. Any regulatory action that may be necessary to minimise harm to patients will be taken once the new information has been carefully reviewed."
A statement from the makers of the drug Merck and Schering-Plough said the finding was likely to be an "anomaly". It said: "Based on the information presented by the study investigator and the analyses conducted independently by the University of Oxford Clinical Trial Service Unit and Epidemiological Studies Unit, MSP believes the cancer finding is likely to be an anomaly that, taken in the light of all the available data, does not support an association with Vytorin (also known as Inegy). "We are committed to working with regulatory agencies to further evaluate the available data and interpretations of those data; we do not believe that changes in the clinical use of Vytorin are warranted. Of course, patients taking Vytorin should talk to their doctor if they have questions."
23 August, 2008
HRT 'boosts quality of life'
Nice to see an admission of how vanishingly small any risk is
Six years after widespread panic about hormone replacement therapy causing cancer and strokes, research suggests it improves quality of life. One of the world's longest and largest trials of hormone replacement therapy has found it can improve sleep, sexuality and joint pain in post-menopausal women. Published today by the British Medical Journal, the results are from a study by the WISDOM research team (Women's international study of long duration oestrogen after menopause). The study involved 2130 post-menopausal women in Britain, Australia and New Zealand, and assessed the impact of combined oestrogen and progestogen hormone therapy on the quality of life.
The average age of women in the study was 63, and 70 per cent of participants did not have menopausal symptoms of hot flushes and night sweats. University of Adelaide obstetrics and gynaecology Professor Alastair MacLennan, who led the Australian arm of the research, said the results were interesting but he was not recommending that women with no symptoms use HRT. "Our results show that hot flushes, night sweats, sleeplessness and joint pains were less common in women on HRT in this age group," he said yesterday. "Sexuality was also improved. Overall, quality of life measures improved. Even when women did not have hot flushes and were well past menopause, there was a small but measurable improvement in quality of life and a noted improvement in sleep, sexuality and joint pains."
Professor MacLennan said studies such as those conducted by WISDOM enabled the risks of HRT to be reduced and benefits maximised when the treatment was tailored to the individual. Early side effects could usually be eased by adjusting the treatment, he said. For most women with significant menopausal symptoms, the benefits of HRT outweigh the risks.
In 2002, an eight-year HRT trial was stopped after five years because researchers concluded the risks were too great, with evidence of more cancers and strokes. The news caused women around the world to abandon HRT, with Australian women reacting more strongly than most. In Europe, about 5 per cent of women stopped treatment, compared with up to 40 per cent in Australia, although many have since returned.
Professor MacLennan said the most recent analyses of the main long-term randomised control trial of HRT - the Women's Health Initiative - showed breast cancer incidence did not increase with oestrogen-only HRT and was only increased in women using combined oestrogen and progestogen HRT after seven years of use. This increased risk was less than 0.1 per cent [That's one tenth of one percent] per year of use. If a woman feels that HRT is needed for quality of life, then doctors can find the safest regimen for her, Professor MacLennan said. She can try going off HRT every four to five years, and can then make an informed choice about whether she takes and continues HRT.
The WISDOM research is independent of the pharmaceutical industry and has been funded by UK, Australian and New Zealand government research bodies. Australian Medical Association state president Dr Peter Ford said women should weigh up the known risks and benefits of HRT. Those with acute menopausal symptoms could gain considerable relief from the therapy. When people are really in distress from those symptoms, its a godsend, quite frankly, to be able to offer it, he said.
A disgusting example of `junk television'
BBC3 has given us yet another helping of mechanically-generated TV designed to scare us about what we eat.
Cheap food is often not very good. Sometimes it might look the part, but the content is frequently sickly and leaves a nasty taste in the mouth. How appropriate, then, that a programme `revealing' this fact should have been shown on BBC3 - the Beeb's yoof TV channel which produces documentaries that seem like a tasty treat on the outside but are actually stuffed with crap.
Britain's Really Disgusting Foods, presented by the mildly amusing Alex Riley, was the search for the worst thing you could eat that is legally available in shops. Riley has thick, black-rimmed glasses and could probably do with a haircut. He looks like a dork and has a vaguely northern accent, but his management calls him `tall, sleek and unconventionally handsome'. Whatever.
He went in search of foods that had the most `stuff' added to them. Unsurprisingly, this didn't mean organic parsnips, but the kind of food churned out by big food processors and sold in your local cash-and-carry.
His first target was something called `cheese alternative'. This is an `analogue', a substance that contains some of the qualities of cheese - it even contains some skimmed milk - but isn't actually produced in the same way as cheese. Instead, it is created by the block load to pad out cheap supermarket food and takeaway pizzas and is packed full of `E' numbers - that is, artificial additives. And it doesn't taste of anything very much, never mind cheese.
If the `cheese' is full of additives, the chicken breasts are full of water. Riley managed to find some in his local Booker cash-and-carry store (yes, bizarrely, it is the same Booker that sponsors Britain's most famous literary prize) which contained just 60 per cent chicken and lots of water. You won't find chicken breasts like this in the local supermarket, but you might find them in your restaurant-bought chicken fried rice or chicken vindaloo. A trader in Smithfield, London's main meat market, told Britain's Really Disgusting Foods that chicken breasts stuffed full of water are popular with Chinese and Indian takeaways.
Another unsurprising target were sausages. They're absolutely full of rubbish, right? Well, actually, not as much as you might think. Riley was most disappointed to find that eyelids, scrotums, anuses and ears aren't allowed into any product labelled `sausage'. In fact, sausages must be 32 per cent meat at least, and most good-quality sausages contain 80 per cent or more.
However there's lots of other stuff you can put into meat products - like connective tissue - which might otherwise be thrown away. You'd have thought in an era of waste-not-want-not eco-frugality that the efficiency of the meat industry in this respect would have been praised. Many processed products are also bulked out with ingredients that are a hell of a lot cheaper than real meat: rusk, soya, colouring, etc. Confront people with the raw ingredients and they will turn their noses up. Offer samples of such a sausage at the posh nosh exhibition the Good Food Show, as Riley did, and people seem to think they're actually quite nice. Just don't mention what's in them.
This only goes to show the pragmatic attitude we Brits have to our food. As long as someone can assure us that what we eat isn't harmful, we'll happily munch away. Restaurants perform much the same trick. It doesn't really matter what you're eating - if it's cooked with half a pack of butter and seasoned well, it's going to taste good. We just love salt and fat, whether it's fine dining or the local takeaway after a heavy session.
As is often the way with this kind of TV show, Riley pulled in an expert or two to suggest that eating this kind of rubbish is responsible for the `wave of degenerative disease' in Britain, without actually detailing why that might be the case (or even proving that it is true). Like the pies he created to show off the worst of British processed food practices, Riley's film didn't have a lot of meat in it.
He did, however, manage one good thing. Booker's magazine for the Good Food Show featured a column by potty-mouthed celebrity chef Gordon Ramsay, which apparently extolled the virtues of Booker's wares to the catering trade. No doubt Ramsay was mortified to be featured in a programme on crap sausages and dodgy chicken; these are the type of catering practices he attacks in shows like Ramsay's Kitchen Nightmares. But that's what you risk if you whore your reputation as a multi-Michelin starred chef to all-comers - just the kind of thing that a young, up-and-coming chef called Gordon Ramsay was railing against 10 years ago.
Britain's Really Disgusting Foods was another prime cut of the kind of no-need-to-watch factual programming mechanically generated by BBC3 and, indeed, by every other channel these days. From Honey, We're Killing the Kids to It's Shit Being an Indian Sweatshop Worker (okay, I made the last one up), factual television has been reduced to junk telly, as obvious and unsatisfying as a Pot Noodle. Yummy!
Century-old drug might cure Parkinson's
A study with mice suggests a century-old drug, methylene blue, could slow or even cure Alzheimer's and Parkinson's disease in small doses, researchers say. "To find that such a common and inexpensive drug can be used to increase and prolong the quality of life by treating such serious diseases is truly exciting," said Bruce Ames, a coauthor of the study at Children's Hospital & Research Center Oakland, in California.
Led by Hani Atamna at the center, researchers studied the drug's effects on laboratory-cultured cells and mice. In very low concentrations -- the equivalent of a few raindrops in four Olympicsized swimming pools -- the drug slows cellular aging and enhances the function of cellular "power plants" called mitochondria, the experimenters said. Their results appeared in the March issue of the Federation of American Societies for Experimental Biology Journal.
The group found methylene blue could prevent or slow mitochondrial decline, specifically that of an important enzyme called complex IV. Mitochondria are the main energy suppliers to animal and human cells.
"The results are very encouraging," said Atamna. "One of the key aspects of Alzheimer's disease is mitochondrial dysfunction, specifically complex IV dysfunction," he went on. Methylene blue seems to expand the brain's "mitochondrial reserve," he added, "essential for preventing age-related disorders."
Discovered in 1891, methylene blue is used to treat methemoglobinemia, a blood disorder. But because high concentrations of methylene blue were known to damage the brain, no one thought to experiment with low concentrations, Atamna's group said. Also, drugs such as methylene blue don't easily reach the brain.
Atamna said methylene blue could become another commonplace lowcost treatment like aspirin, prescribed as a blood thinner for people with heart disorders.
22 August, 2008
You better eat your . . . Frosted Flakes?
The food puritans are critical but you will note the total lack of any double-blind evidence that there is anything wrong with Frosted Flakes. Given the way in which double-blind studies overturn conventional wisdom, I would not be surprised if Frosted Flakes are in fact good for you. It appears to be their sugar content that is drawing objections but if sugar is bad for you we should all be dead
Olympic legend Michael Phelps will appear on boxes of the Kellogg's brand sugar cereal, drawing sharp criticism from health experts worried about the message he'll be sending to children across America. "I would not consider Frosted Flakes the food of an Olympian," said nutritionist Rebecca Solomon of Mount Sinai Medical Center. "I would rather see him promoting Fiber One. I would rather see him promoting oatmeal. I would even rather see him promoting Cheerios."
The announcement yesterday that Phelps, 23, winner of a record eight gold medals at the Beijing Olympics, would grace Frosted Flakes and Corn Flakes boxes instead of the traditional athlete's choice of Wheaties left many perplexed. Frosted Flakes has three times the amount of sugar as Wheaties and 1/3rd the fiber.
This doesn't matter much to a virtuoso swimmer who consumes 12,000 calories a day. Still, in a country where childhood obesity is an alarming issue, Phelps' iconic image sharing space with Tony the Tiger sends the wrong message, experts say. "For a guy like Michael Phelps who isn't worried about obesity because he's burning thousands of calories as an athlete...eating Corn Flakes and Frosted Flakes every so often is not an issue," Solomon said.
The Phelps-emblazoned cereal boxes hit supermarket shelves in mid-September.
Taking your tablets with fruit juice limits the effect
Anyone taking medication should beware of drinking fruit juice, Canadian researchers have found. Grapefruit, orange and apple juice can all have a significant effect on the uptake of drugs - either lowering or increasing their effectiveness. While the influence of grapefruit juice is already well known, and some drug labels caution against drinking it with medicines, the latest research has extended the need for care.
Results presented to the American Chemical Society meeting in Philadelphia yesterday by David Bailey, Professor of Physiology, Pharmacology and Medicine at the University of Western Ontario, show that fruit juices can limit the effects of several drugs, including three beta-blockers used to treat high blood pressure, the cancer drug etoposide and some antibiotics.
In tests, healthy volunteers took fexofenadine, an antihistamine. They swallowed the drug with either grapefruit juice, water containing naringin - the chemical that causes the fruit's bitter taste - or plain water. When the medicine was taken with grapefruit juice, only half as much of the drug was absorbed into the body as it was with water.
Naringin and similar substances in orange and apple juices appeared to block a "transporter" molecule called OATP1A2 which helped to shuttle drugs from the small intestine to the bloodstream.
Drugs whose levels in the body were boosted by grapefruit juice were affected by a different mechanism that prevented them being broken down. Professor Bailey originally discovered the drug-boosting effects of grapefruit 20 years ago. He said: "I'm sure we'll find more drugs that are affected in this way." Most medicines should be taken only with water, he said.
Breakthrough could end reliance on blood donations
HUMAN blood has been grown in the laboratory for the first time in research that promises an almost limitless transfusion supply. The achievement by scientists in the US could lead to trials of the blood within two years, and ultimately to an alternative to donations that would transform medicine.
If such blood was made from stem cells of the O-negative blood type, which is compatible with every blood group but is often in short supply, it could be given safely to anybody who needs a transfusion. Stem-cell-derived blood would also eliminate the risk of transmitting the pathogens that cause hepatitis, HIV and Creutzfeldt-Jakob disease through transfusions.
Scientists behind the advance said that it has huge therapeutic potential and could easily become the first application of embryonic stem-cell research to enter widespread clinical use. "Limitations in the supply of blood can have potentially life-threatening consequences for patients with massive blood loss," said Robert Lanza, of Advanced Cell Technology in Massachusetts, who led the experiments.
"Embryonic stem cells represent a new source of cells that can be propagated and expanded indefinitely, providing a potentially inexhaustible source of red blood cells for human therapy. The identification of a stem cell line with Onegative blood type would permit the production of compatible 'universal donor' blood."
Blood comes in four groups, A, B, AB and O, and in two rhesus types, positive and negative, and only some of these are compatible with one another. A person with type A, for example, can donate to people with type A or AB, and receive blood of type A or O. Only O-negative blood can be given to any patient. While there is no national shortage of donated blood in Britain, O-negative blood sometimes runs low. It is also used widely in military medicine.
The research also has more immediate clinical promise for efforts to turn embryonic stem cells into other types of tissue, to treat conditions such as diabetes and Parkinson's. One of the biggest safety hurdles that must be cleared before stem-cell therapies enter clinical trials is the risk of uncontrolled cell growth causing cancer. Red blood cells, however, do not have nuclei that carry the genetic material that goes wrong in cancer, and thus should not present this danger. "This could be one of the biggest breaks for the early clinical application of embryonic stem cells," Dr Lanza said. "There is still work to be done, but we could certainly be studying these cells clinically within the next year or two."
While a few red blood cells have been created from embryonic stem cells before, the ACT team is the first to mass-produce them on the scale required for medical use. They also showed that the red cells were capable of carrying oxygen, and that they responded to biological cues in similar fashion to the real thing. About two thirds had no nucleus, which suggests that they are fully fledged adult red blood cells, and the researchers hope to bring this closer to 100 per cent. Details of the research are published in the journal Blood.
Though embryonic stem cells were used in this experiment, it may be possible to create blood from reprogrammed adult cells, also known as induced pluripotent (IPS) cells. These would circumvent some ethical objections to the use of embryonic tissue.
Independent scientists welcomed the work. Professor Alex Medvinsky, a blood stem cell expert at the University of Edinburgh, said: "The problem with relying on donated blood is that there are always shortages. The ability to generate red blood cells in very large numbers would be a very big thing."
21 August, 2008
Psychologists find video games 'not all bad'
PLAYING video games improves manual dexterity among surgeons, making them faster and less likely to make mistakes, researchers have found. The findings were contained in a raft of research about how video games effect the people who play them, discussed at the Annual Convention of the American Psychological Association in Boston.
"The big picture is that there are several dimensions in which games have effects," including their content, how they are played, and how much, said psychologist Douglas Gentile of Iowa State University. "This means that games are not 'good' or 'bad' but are powerful educational tools and have many effects we might not have expected they could."
Dr. Gentile presented several studies on video games including one involving 33 surgeons specializing in laparoscopy, the use of a thin lighted tube to inspect and treat various conditions in the pelvic and abdominal cavities. Laparoscopic surgeons who played video games were 27 per cent faster at advanced surgical procedures, and made 37 per cent fewer errors, compared to their non-gaming colleagues, the study found.
Studies involving high school and college students confirmed previous findings about the social effects of playing violent video games, the Iowa State researchers said. Students who played violent games were more hostile, less forgiving, and more apt to view violence as normal, than peers who played non-violent games. But students who played "prosocial" games got into fewer fights at school and were more helpful to other students, the researchers reported.
Yet another study at Fordham University measured the effect of learning a new video game on problem-solving skills in middle-school-age children and found that "playing video games can improve cognitive and perceptual skills." "Certain types of video games can have beneficial effects improving gamers' dexterity as well as their ability to problem-solve - attributes that have proven useful not only to students but to surgeons," the researchers found.
Fortifying bread with folic acid is 'no protection from heart disease'
Taking vitamin B or folic acid supplements does not prevent death in patients with heart disease, a study has shown. The research is the latest to demonstrate that money spent on vitamins is often wasted. But it also suggests that fortifying bread with folic acid - a measure under consideration in Britain to prevent birth defects - would not have the additional advantage of protecting the nation's hearts.
Earlier work suggested that folic acid, either alone or combined with vitamins B12 and B6, reduced levels in the blood of homocysteine, an amino acid linked to a higher risk of heart attack. Proponents of vitamin supplements argued that lowering homocysteine levels through supplements would also reduce heart attacks. But the new study seems to disprove that.
While homocysteine levels did fall by 30 per cent after a year of treatment with folic acid and B12, there was no corresponding fall in heart attacks or strokes. In the group given folic acid, there was a decline in strokes, but an increase in cancer, though neither was significant.
The study, published in the Journal of the American Medical Association, involved more than 3,000 patients in two Norwegian hospitals between 1999 and 2006. Patients were given folic acid plus vitamin B12 and vitamin B6, or folic acid plus B12, B6 alone, or a placebo. "Our findings do not support the use of B vitamins as secondary prevention in patients with coronary artery disease," the team concluded.
Since folic acid fortification of flour began in the US and Canada ten years ago, deaths from stroke have fallen faster than in England and Wales, where fortification has been discussed endlessly but never implemented.
Alexander Technique effective for back pain
An alternative therapy used to improve posture and to help women to cope with labour pain can be more effective at treating backache than conventional treatments, a study suggests. Combining exercise with practising the Alexander Technique could significantly reduce back pain and improve mobility, researchers found.
The technique was developed by the actor Frederick Alexander (1869-1955) to help his vocal and breathing problems. It is designed to change the way people move their bodies, with an emphasis on balance, posture and co-ordination. A team from the universities of Bristol and Southampton compared the effectiveness of massage, exercise and the Alexander Technique in 579 patients with back pain. Those who had received 24 lessons in the Alexander Technique reported 18 fewer days of back pain over four weeks compared with those who had been taking exercise alone, according to the study published online by the British Medical Journal today.
20 August, 2008
Basic mathematical ability appears to be innate
Those pesky genetics again! Note that the findings concern differences between Aboriginal groups, not black/white differences. Note also that once again culture is not found to be the explanation for ability differences that Leftists routinely claim. Leftists would have predicted that the more acculturated blacks would have done better. The finding of zero differences due to culture makes it very hard to assert that culture is the explanation for lower black average IQ. Mathematical ability is of course a major component of IQ
Basic mathematical ability appears to be innate, or hard-wired into the human brain, according to an international study. The research found that outback Aboriginal children with only a few number words in their language can still "count" just as well as English-speaking children.
The results of the joint study by University College London and Melbourne University, challenges notions that we need language in order to think and count. It also suggests that mathematical disabilities such as dyscalculia, the little known maths version of dyslexia, is a genetic or neurological disorder rather than a memory or language deficiency. The results have been published this week in the Washington-based journal Proceedings of the National Academy of Sciences.
Study co-researcher Bob Reeve, associate professor at Melbourne University's School of Behaviourial Science, said the findings may have implications for early maths teaching as well as the early identification and treatment of dyscalculia. "The (teaching) language needs to support or focus on the more basic concepts and that may be slightly different to what is going on now," Professor Reeve told The Australian.
The study tested 45 indigenous children aged between four and seven years old. Researchers contrasted children of the Walpiri language group in the Central Desert and that of the Anindilyakwa language group on Groote Eylandt in the Gulf of Carpentaria with a group of English-speaking indigenous children in Melbourne.
Using simple tasks with sticks, counters and play-dough, the study found that the outback children, despite having just three or four generic number words such as "one", "two" and "more than two", still demonstrated strong numeracy skills matching the English-speaking children in Melbourne. This contradict earlier results that found that some indigenous communities in the Amazon with similarly few number words in their language had difficulty with some basic mathematical tasks.
Professor Reeve said the Australian findings suggested that while language is needed for more complex mathematical tasks, humans nevertheless have an innate "starter kit" for mathematics that is likely in the genome. "Nobody is disputing the fact that you need language to build a more complicated set of ideas, but (language) isn't the starter kit," he said. "There is a clear basis on which children can build, but it isn't a linguistic basis."
One of the co-authors is UCL's Professor Brian Butterworth who has written about dyscalculia in his book The Mathematical Brain, and and has written a test to screen for the disorder. Studies have suggested that dyscalculia, in which sufferers are unable to carry out basic mental arithmetic without a calculator, could affect between 3.4 and 10 per cent of the population. "Whether we can remedy the situation (for dyscalculacs) by particular forms of instruction is interesting, but recognising the problem is the first point here," Professor Reeve said.
Breast cancer hope as brittle bone drug gets clinical trial in UK
A treatment for brittle bones can have a dramatic effect on breast cancer when combined with chemotherapy, research has shown. Scientists found that the two drugs acted together to slow down the growth of tumours. In mice given the therapy, growing breast tumours were almost stopped in their tracks.
A clinical trial is under way in the UK that could lead to the treatment becoming widely available to patients. Since both drugs are already well established, and need only the terms of their use to be changed, this may not take long, the researchers suggest. The therapy involves the breast cancer chemotherapy agent doxorubicin and the bisphosphonate drug zoledronic acid.
In the mouse study, doxorubicin was given first, followed 24 hours later by zoledronic acid. When the order was reversed, or the drugs administered on their own, the treatment had little effect. The scientists said that the chemotherapy drug appeared to "prime" the tumour and make it sensitive to the bisphosphonate. Tests showed that the treatment triggered a "suicide" response known as apoptosis in the cancer cells, causing them to self-destruct. It also blocked angiogenesis, the process by which blood vessels are created that fuel tumours with oxygen and nutrients.
The researchers, from the University of Sheffield and the University of Kuopio in Finland, published their findings in the Journal of the National Cancer Institute.
Bisphosphonates are normally used to prevent bone thinning in patients with osteoporosis. They also protect bones from the destructive effects of tumours. For this reason they are sometimes given to men with prostate cancer, which has a habit of spreading to the bones. The new study showed that zoledronic acid can have a powerful direct effect on breast cancer without any bone involvement.
The results of the clinical trial, led by Professor Robert Coleman, of the University of Sheffield, should be known this year.
19 August, 2008
University of New Mexico opens quack medicine center
A fool and his money are soon parted, I guess
Many academic health centers offer programs that include traditional Chinese treatments or Ayurvedic medicine from India. The University of New Mexico goes beyond that, says management of its new Center for Life. "The uniqueness of our program is that we not only embrace Eastern and Western philosophies, but we try to integrate the traditions of New Mexico," said Dr. Arti Prasad, the center's director. Thus, Native American healers and Hispanic curanderas are invited to work with patients at the clinic.
The Center for Life, which opened Friday, offers what Prasad prefers to call "complementary medicine" - augmenting modern medicine with practices and treatments that may go back thousands of years in other cultures. The philosophy has its basis in preventing disease, what Prasad describes as "keeping the body in balance, staying healthy, exercising, eating healthy and doing good things in your life."
Western medicine works to find disease early with such tests as mammograms, while Eastern medicine steps in earlier to try to prevent disease, she said. If there's an imbalance in the body and a person becomes ill, Eastern medicine tries to get the body back in balance, she said. The center's physicians work with yoga instructors, doctors of Oriental medicine or hypnotherapists "to achieve one goal of health and wellness in our patients," said Prasad, a native of India who graduated from conventional Western medical schools but grew up with traditional folk medicine as part of the Indian lifestyle.
The clinic is located miles from the university's hospital. That tends to reduce the anxiety many patients feel in a hospital setting, Prasad said. "That's different from a place where you can sense healing right from the beginning," she said. People enter through a reception area with a water fountain. "The sound of water is very soothing and healing," she explains.
Vibrant, sherbet-tone colors were chosen specifically for healing, giving a sense of joy and liveliness. Music plays throughout the clinic and in the rooms - which are called treatment rooms, not examination rooms. Instead of numbers, the rooms have names: Heal, Hope, Calm, Relax, Pleasure, Longevity. Instead of examination tables and fluorescent lights, they have small water fountains, massage tables and cushy furniture.
The building is new, but the center began last year when the Health Sciences Center expanded the integrated medicine section it started in 2001. Prasad acknowledges that some doctors don't support the idea of integrative medicine, but said more patients are demanding options. "It's here because our consumers are wanting it, our consumers are asking these questions so we have to go out and find the answers for them," she said.
FDA concludes bisphenol A chemical used in baby bottles, canned food is not dangerous
One in the eye for the alarmists -- but it won't change their minds. They NEED to believe in their own superior wisdom
Despite ongoing safety concerns from parents, consumer groups and politicians, a chemical used in baby bottles, canned food and other items is not dangerous, federal regulators said Friday. Food and Drug Administration scientists said the trace amounts of bisphenol A that leach out of food containers are not a threat to infants or adults. The agency acknowledged that more research is needed to fully understand the chemical's effects on humans, and noted "there are always uncertainties associated with safety decisions."
The FDA previously declared the chemical safe, but agreed to revisit that opinion after a report by the federal National Toxicology Program said there was "some concern" about its risks to infants. The plastic-hardening chemical, similar to the hormone estrogen, is used to seal canned food and make shatterproof bottles. It is also used in hundreds of household items, ranging from sunglasses to CDs.
The FDA's draft report was greeted with enthusiasm by the American Chemistry Council, which has defended the chemical's safety. "FDA is the government agency we rely upon to assess food-contact products. They've assessed this issue in great detail and their conclusion is very reassuring," said Steve Hentges, an executive director with the council.
But environmental groups were quick to criticize the agency's conclusions, which they said relied on industry-funded studies. "It's ironic FDA would choose to ignore dozens of studies funded by (the National Institutes of Health) - this country's best scientists - and instead rely on flawed studies from industry," said Pete Myers, chief scientist for Environmental Health Sciences. Myers said the agency disregarded recent studies of bisphenol's effects included in the National Toxicology Program's April draft report. That group's review of animal studies suggested low doses of bisphenol can cause changes in behavior and the brain, and that it may reduce survival and birth weight in fetuses. A final version of the group's findings is expected next month.
Commenting on those studies in its 105-page assessment, the FDA said they had "inconsistencies and inadequacies which limit the interpretations of the findings."
About 93 percent of Americans have traces of bisphenol in their urine, according to the Centers for Disease Control and Prevention. And while studies have suggested the chemical can disrupt hormones in mice, the FDA concluded that the levels people are exposed to are thousands of times below what are dangerous. The FDA released its preliminary re-evaluation ahead of a September meeting where outside advisers will debate the chemical's safety.
Many lawmakers at home and abroad aren't waiting for the agency to complete its review. Canada has announced its intention to ban the use of the chemical in baby bottles, and state and federal lawmakers have introduced legislation to ban bisphenol in children's products.
Some environmental groups questioned the timing of the FDA's report, noting California lawmakers are expected to soon vote on removing bisphenol from children's products. If signed into law, it would be the first state ban of the chemical. "For this to come out on a Friday afternoon, just before California takes action, it definitely raises some eyebrows," said Renee Sharp, a senior analyst with the Environmental Working Group.
At least 10 states besides California are also considering bills to restrict use of the chemical. More than 6 billion pounds of bisphenol are produced in the U.S. each year by Dow Chemical, BASF, Bayer AG and other manufacturers.
18 August, 2008
Rutgers University study links moisturisers to skin cancer
Only worry if you are a gene-altered hairless mouse exposed to heavy doses of UV light.
Moisturizers used by millions of people have induced skin cancer in experiments on mice, a new study says. Researchers at Rutgers University in New Jersey tested four common skin creams on gene-altered hairless mice exposed to heavy doses of cancer-causing UV light. The scientist who led the study cautioned that rodent skin was more sensitive than human skin, while other experts said they had reservations about the relelvance of the study's conclusions.
Rates of non-melanoma skin cancers increased between 24 and 95 per cent compared to control mice not treated with creams, the study found. Non-melanoma skin cancer is very common in humans, and is curable surgically. In very rare cases, however, it can prove fatal.
When the scientists, led by Allan Conney, repeated the experiments with a made-to-order cream missing several suspect ingredients - including mineral oil and sodium lauryl sulphate - the cancer rates dropped sharply. Dr Conney said further studies were needed to test the impact of topical creams on people as rodent skin, usually covered by fur, is thinner and more permeable than human skin.
His findings were published in the Journal of Investigative Dermatology, part of the Nature Publishing Group in Britain. Experts familiar with the study doubted its significance for humans. "The UV source used to pre-sensitise the mice is a very poor surrogate for sun exposure,'' said Brian Diffey, an emeritus professor at Newcastle University in Britain. The dose the rodents received exceeded what most people would experience in a lifetime, he said.
Gordon McVie, a senior consultant at the European Institute of Oncology said: "This has no relevance to causation of human skin cancer and does not prove in any way whatever that moisturising creams are cancer-causing in humans.''
The internet shrinks your brain? What rubbish
One lot of assertions is countered by another lot of assertions below.
Winners of the Nobel Prize for Literature are entitled to grand pronouncements, or else what is it for? So Doris Lessing, last winter, anathematised the entire internet, declaring that it had "seduced a whole generation into its inanities". According to Lessing, the web helped to create "'a fragmenting culture, where our certainties of even a few decades ago are questioned, and where it is common for young men and women who have had years of education to know nothing of the world".
One might wonder how she knew this with such certainty. How many of these young men and women had she met, and held conversations with? Slightly more, perhaps, than the average immobile person in her late eighties.
But Lessing has received confirmation in recent weeks from much more contemporary quarters. In the latest Atlantic Monthly, the headline over a major article by Nicholas Carr asked the question: "Is Google making us stupid?" to which Carr's answer was a Dorisian affirmation. Not long afterwards, Bryan Appleyard penned a long piece entitled "Stoooopid... why the Google generation isn't as smart as it thinks", which - as you can imagine - also took the Lessing line.
"Once," wrote Carr, "I was a scuba diver in the sea of words. Now I zip along the surface like a guy on a jet ski." The culprit was the net, which, with its search engines, YouTubes, blogs and Facebooks, seemed to be "chipping away my capacity for concentration and contemplation". And not just his. Carr quoted a writer who blamed the internet for changing his mental habits. "I can't read War and Peace any more," this writer complained, leaving unclear whether he was trying to re-read Tolstoy's masterpiece, or had got halfway through before webweariness overtook him.
Carr's view was that there are two kinds of reading: deep reading, which - essentially - is books, and web reading, where all we're doing is the much lesser decoding of information. In the first we make "rich mental connections" and in the second we just don't. In one we are properly engaged, in the other we ain't. "In the quiet spaces opened up by the sustained, undistracted reading of a book," says Carr, invoking an ideal, "or by any other act of contemplation, for that matter, we make our own associations, draw our own inferences and analogies, foster our own ideas." With the net and its instant access to information we turn into "pancake people", widely and thinly spread.
Appleyard had just been inside that quintessential British experience-former, the intercity train carriage. On the train to Wakefield, with his new 3G iPhone, he was "distracted from distraction by distraction". There were the calls, the texts, the e-mails, "and I'd better throw in the 400-odd news alerts that I receive from all the websites I monitor via my iPhone". I get seven or eight a day on my phone - Sky news, Tottenham Hotspur and London weather. Four hundred on one train trip seems excessive. Anyway... "The digital age is destroying us by ruining our ability to concentrate... it's killing me and it's killing you," says Appleyard, who might die more slowly if he elected to receive fewer news alerts.
"Attention," he asserts, "is the golden key to the mystery of human consciousness... the opposite of attention is distraction, an unnatural condition." Which argument, if taken to its logical conclusion, would make the idiot savant, with the inability to be distracted, the most natural human being of all.
The rot set in with television, but "the internet multiplies the effect a thousandfold... Now teenagers just go to their laptops on coming home from school and sink into their online cocoon," wasting their time on stuff like MySpace on which, apparently, they create connections which are all "threadbare", lacking "the complexity and depth of real-world interactions", lacking in loyalty and feeling.
Appleyard fears that we are now "infantilised cyber-serfs", whose lives the internet has made easier, "but only by destroying the very selves that should be protesting at every distraction, demanding peace, quiet and contemplation". Yes, we all should all be monks. Matins, then work in the fields, then simple food, then Compline, some contemplation, then up - slowly - to the Scriptorium to illuminate some manuscripts, supper, prayers and bed.
How often do such Weh ist mir [Woe is me] arguments rest on an idea of our "natural" selves being alienated by the world of progress? Wasn't it better when we all skinned our own rabbits and made our own music? Let us salute the ideal, St Simeon Stylites, up his pillar in the Syrian desert. Now there was an undistracted man.
Let us begin then at the level of personal experience. I have no problem with reading long novels, despite being a daily and constant user of the internet. I was one of the few people I knew who had read War and Peace 35 years ago, and I still am. Far from turning me into a bibliphobe, the internet has made it much easier for me to find and buy books that were hard to get before.
Nor do I recognise in Lessing's and Appleyard's strictures the experiences of my own daughters. I think they know, not just as much as Lessing did in her teens, but a lot more. Nor, from what I can see, are their Facebook contacts "threadbare". They are almost all people the girls know in real life and see regularly, supplemented with contacts that might otherwise have easily been lost, such as friends from earlier schools. In this sense the internet has helped my kids' social life be just as rich, if not richer, than my own was.
How can, for example, the Google project to place on the internet as many books as possible be productive of anything other than greater learning? What we are asked to do is to look. If we have that capacity, then we don't need to be ordained into the learned priesthood, or try to wangle ourselves library cards to which we aren't entitled. Just type three words, in the right order, and as Aladdin says, Open Sesame, and connections are made - some predicted, many fortuitous. Perhaps it is this uncontrollable, self-sustaining spread of knowledge that threatens the "certainties" that Lessing recalls.
Of course, what all three of my Jeremiahs entirely miss about the internet is its quality of engagement. That's what makes the new era so much better than the television age. As Clay Shirky, the American writer, put it, the new media are a triathlon: "People like to consume, but they also like to produce, and they like to share..." Isn't that superior, he asks, to being stuck in a basement watching reruns of Gilligan's Island? The challenge is not to lament, but to equip, to teach ourselves how to search and how to discriminate. A GCSE [diploma] in search engine skills, perhaps.
One injection 'vaccine' cure for arthritis within five years
A single injection that could cure rheumatoid arthritis is being developed by British scientists. The treatment works like a vaccine and could be available within five years. Cells would be taken from the body, altered, and injected back into the affected joint.
A team at Newcastle University will now test the vaccine on volunteers with the disease. Scientists in the field are extremely excited about the development. There are 350,000 people in the UK with rheumatoid arthritis, which is a condition where the body's immune system attacks the joints, unlike oestoarthritis which is more like wear and tear of the joints. Rheumatoid arthritis is difficult to treat because it is caused by a malfunctioning immune system, causing inflammation in the wrong places.
Prof Alan Silman, medical director of the charity Arthritis Research Campaign, which funded the research, said: "This is an important potential cure. It is possible one injection could switch off the abnormal immune response. "If it works it could reverse the disease and stop further episodes."
The Newcastle team will test the effectiveness of the new vaccine in eight volunteers with rheumatoid arthritis from the Freeman Hospital as part of a pilot study, which could then lead to larger trials.
The vaccine works by reprogramming the body's own immune cells. Using chemicals, steroids and Vitamin D, the team has devised a way to manipulate a patient's white blood cells so they surpress, rather than activate, the immune system. It is thought the cells will then act as a brake on the over-reacting immune system and stop it attacking its own joints. Although a similar technique has been used in cancer research, this is the first time it has been adapted to rheumatoid arthritis.
John Isaacs, Professor of Clinical Rheumatology at Newcastle University's Musculoskeletal Research Group, who is leading the team, said that although the work was in a very early, experimental stage it was "hugely exciting". "Based on previous laboratory research we would expect that this will specifically suppress or down regulate the auto-immune response," he said. Samples will be taken two weeks after the injection to establish whether it has induced the expected response.
The team also hope to find out if the vaccine is effective only in the joints it is injected into, or whether the new cells spread throughout the body. Prof Silman said the treatment may prove expensive as each patient would have to have their own cells taken and manipulated rather than a drug which can be made in bulk and prescribed to all people with a condition. He said it would be unlikely that the vaccine could be offered in normal local hospitals because of the expertise necessary to manipulate the cells in the laboratory.
It raises fears the vaccine would have to go through the National Institute for health and Clinical Excellence cost effectiveness tests. But if the vaccine did work with a one off injection and completely stop the disease it is likely to offer such a huge benefit to the patient that even a relatively large price may be deemed acceptable. Prof Silman said he expected the jab to cost less than $50,000. The research is being funded by medical research charity the Arthritis Research Campaign, which is providing $432,000 over 18 months.
17 August, 2008
"Junk" diet makes kids naughty
What utter crap! All the data show is that mothers who fed their kids disapproved food had kids who were less well behaved -- i.e. working class mothers had rattier children. It's entirely explicable as a class effect, not a diet effect
Eating junk food as toddlers makes kids more badly behaved at school, medics reveal today. Sugary and fatty snacks have been blamed for naughtiness and poor concentration, leading to campaigns for healthier lunches. But research has now found that if children are given bad diet as young as THREE the damage has already been done by the time they go to school.
Studies showed that pupils who had been fed processed grub as toddlers were the worst-behaved in class and performed the worst in tests. The findings emerged from a major study by the University of London's Institute for Education. The probe, part of the Bristol Children of the 90s medical research project, looked at data from 14,000 children. It found that those on a junk food diet aged three were less likely to achieve the expected levels of improvement between six and ten.
Dr Pauline Emmett, a nutritionist from the University of Bristol, said: "We are confident that this is a robust association. "It indicates that early eating patterns have effects that persist over time, regardless of later changes in diet. So it is very important for children to eat a well-balanced diet from an early age if they are to get the best out of their education." The study showed that a child's diet at a later age has less impact on their school performance.
Turkey twizzlers, burgers and chips have been blamed for behaviour problems and the Government has spent millions overhauling school meals following a campaign led by TV chef Jamie Oliver. Many schools have banned junk food completely as a result. Improved meals are expected to boost performance in the classroom.
British fat Fascists want to seize kids
Grossly overweight children may be taken from their families and put into care if Britain's obesity epidemic continues to escalate, council chiefs said yesterday. The Local Government Association argued that parents who allowed their children to eat too much could be as guilty of neglect as those who did not feed their children at all.
The association said that until now there had been only a few cases when social services had intervened in obesity cases. But it gave warning that local councils may have to take action much more often and, if necessary, put obese children on "at risk" registers or take them into care. It called for new guidelines to be drawn up to help authorities deal with the issue.
There have been some reported cases where children under 10 have weighed up to 14st (89kg) and a three-year-old has weighed 10st - putting them at a high risk of diabetes and heart disease. Only last week a 15-year-old girl in Wales was told by doctors that she could "drop dead at any moment" after tipping the scales at 33st.
David Rogers, the Local Government Association's public health spokesman, said that by 2012 an estimated million children would be obese and by 2025 about a quarter of all boys would be grossly overweight. "Councils are increasingly having to consider taking action where parents are putting children's health in real danger," he said. "As the obesity epidemic grows, these tricky cases will keep on cropping up. Councils would step in to deal with an undernourished and neglected child, so should a case with a morbidly obese child be different? If parents consistently place their children at risk through bad diet and lack of exercise, is it right that a council should step in to keep the child's health under review?"
"The nation's expanding waistline threatens to have a devastating impact on our public services. It's a huge issue for public health, but it also risks placing an unprecedented amount of pressure on council services."
The association called for a national debate on how much local authorities should intervene in obesity cases. As a basic minimum, social services or health visitors should talk to the families involved, give them advice and show them how to provide healthy meals. "But in the worst cases [the children] would need to be put on `at risk' registers or taken into care."
Last year Cumbria County Council put an eight-year old girl into care as she was dangerously overweight. Anne Ridgway, of Cumbria Primary Care Trust, said that it was extremely rare for a child to be put into care just because of their weight. "Even then the care proceedings may well have been instigated because of related problems rather than exclusively because of their weight," she said. Extreme cases of obesity could become a child protection issue because obesity "can have very serious consequences for a child's health and the parental behaviour that leads to childhood obesity can be a form of neglect".
Tam Fry, of the National Obesity Forum, said: "Children who are dangerously overweight should be brought into hospital, where they can be given 24-hour care for several weeks or months. But their parents should have access to them."
The Conservative Party said that taking children into care was a serious step. Andrew Landsley, the Shadow Health Secretary, said that in many cases "it would be better to help the parents provide better nutrition for their child rather than break up the family".
Why seizing fat kids would solve nothing
A recent Department of Health study showed that one schoolchild in three is either overweight or clinically obese - and they were the ones who agreed to be weighed. A fifth of the children opted out of their appointment with the scales. I'm willing to bet that an even higher proportion of them would have been wearing clothes labelled "XXL".
I usually meet at least one fat child a day in my surgery and I can guarantee that they will have been brought along to talk about a cough, a verruca, anything apart from their weight. More often than not the accompanying parent is also markedly overweight.
We learn how to cope with stress on our mother's knees. It would seem that these children have learnt how to comfort eat from one parent or both. I know that these children will grow up to suffer heart problems, premature arthritis and early-onset diabetes as a direct result of their obesity. I also know that if I comment on it their parent will go on the defensive. They usually make light of it, asking why I am making a big deal about a couple of inches of puppy fat.
Some experts argue that these children will do better if they are removed from the parental home. They need to consider two issues. First, the child may have developed the comfort-eating habit as a way of coping with stress, so being moved to another family will not undo that. Secondly, removal from the family is the most stressful event that could happen in a young child's life and could well lead to even more overeating.
It is easy to talk about "tough love" and locks on the fridge door but the only way to get to the root of the problem is to deal with the family as a whole.
16 August, 2008
Obese people can be healthy too
Some obese people are in good health and are not predisposed to heart ailments, according to a new study. And another shows that being slim doesn't automatically protect you from heart-related illnesses such as high blood pressure and cholestrol, and diabetes.
In the first study, conducted by Norbert Stefan and a team at the University of Tubingen in Germany, the researchers studied the fat around the internal organs and under the skin of 314 individuals with an average age of 45. The obese individuals in the study were divided into two groups: those who were resistant to insulin and those who were not. Insulin resistance is a pre-diabetic condition, meaning some symptoms of diabetes are present and progression to full-blown diabetes is likely.
Those who were obese and resistant to insulin had more muscle fat, fat in their livers and thicker carotid-artery walls - an early sign of artery narrowing, which is a heart-disease risk factor - than obese individuals without insulin resistance, the study, published in the Archives of Internal Medicine, found. As well, obese individuals who were not insulin-resistant had no differences in artery-wall thickness from the normal-weight group. "We provide evidence that a metabolically benign obesity can be identified and that it may protect from insulin resistance and atherosclerosis,'' the researchers wrote.
The second study carried out by Rachel Wildman at the Albert Einstein College of Medicine in New York examined body weight and cardio-metabolic abnormalities - including high blood pressure, elevated triglycerides and low levels of so-called good cholesterol - in 5440 individuals between 1999 and 2004. The study found that some obese people were metabolically healthy. "Obese individuals with no metabolic abnormalities were more likely to be younger, black, more physically active and have smaller waists than those with metabolic risk factors,'' the authors wrote.
Those of normal weight with health risks were older, less active and had a larger waist than the average population. Among the US population aged 20 and older, some 23 per cent (16 million adults) of normal weight had metabolic abnormalities, while 51 per cent (36 million) of overweight adults and 32 percent (19.5 million) of obese adults "were metabolically healthy", the authors wrote.
Patients 'free from cancer' after immune-boost treatment
Cancer patients have been left free of the disease after being treated with a new drug which harnesses the power of their own immune cells. Four of 38 patients with non-Hodgkin's lymphoma have seen the disease disappear following treatment, while five others saw reductions of 50 per cent in their tumours. The drug, which could prove cheaper than other similar therapies, works by activating the body's own defences to attack the cancer.
The results have been described as an "exciting" and "significant" development in the use of immunotherapy, the process of using the body's own immune system to fight disease. While the trials were only carried out on patients with the blood cancer, it is hoped the methods can be adapated to tackle other cancers. The disease claims the lives of more than 150,000 people in the UK every year and more than one million people are suffering from cancer at any one time.
Earlier this year doctors announced that a patient with advanced skin cancer was free of the disease two years after they injected him with billions of his own immune cells using a different method. However, experts warned at the time that the process could prove extremely expensive. The development of the drug could prove a much cheaper alternative way of providing immunotherapy treatments.
Professor Peter Johnson, Cancer Research UK's chief clinician, said: "These exciting preliminary results come from using them to harness the body's own immune response in a new way. Although the side effects need to be monitored carefully, we hope that this type of treatment will prove to be active in larger trials in the future"
"This a significant study," said Dr Cassian Yee, Fred Hutchinson Cancer Research Center, Seattle, who has had significant results using the alternative method of treating patients with white blood cells grown in the lab. "It remains to be seen if most of the responses are longlasting. Certainly the results are very promising."
The drug, which has been developed by Micromet, in Bethesda, Maryland, was trialled by a team led by Dr Ralf Bargou at University of Wuerzburg in Wuerzburg, German. Of the 38 patients with non-Hodgkin's lymphoma who took part in the most recent study, two of the seven who received the highest doses of the drug saw their cancer disappear while five others had reductions in their tumours of more than 50 per cent. One patient on a lower dose also became cancer free and remains so after more than a year. The results, published in the journal Science, are encouraging because they suggest that the bigger the dose, the bigger the effect.
Coauthor of the study Dr Patrick Baeuerle, of Micromet, said all seven who received the highest dose responded to the drug. "Two of the seven had a complete response, and five a partial regression (greater than 50 per cent reduction of tumour).". The longest duration of a response was so far seen in a patient who received one quarter of their dose. After 13 months, he remains free of the blood cancer.
There are adverse side effects involved, however, such as fevers and chills, occasionally with confusion and tremor, though all stopped after treatment ceased. Now a further trial is investigating how the drugs works in patients with another form of blood cancer, called acute lymphoblastic leukaemia. Trials with a similar drug are also under way on patients with another type of cancer, which affects glandular tissue and can appear in the lungs, prostate, breast, colon and elsewhere in the body.
Red Bull gives you wings - and heart trouble
ONE can of Red Bull might "give you wings" but it could also cause a heart attack. Young people are being warned to treat the caffeine drink "with caution" after Australian research revealed it could increase risk of cardiac arrests and even death.
The study found one can of sugar-free Red Bull can cause the blood to become sticky -- an indicator of cardiovascular problems such as stroke. Lead researcher Scott Willoughby, from Adelaide Hospital, yesterday warned that the drink "could be deadly" for people with heart abnormalities.
While the prevalence of sudden cardiac death is very low, "it could be more deadly for people who have an unknown cardiovascular abnormality", Dr Willoughby said.
University student Tim Piper admits to drinking Red Bull a "couple of times a week" on its own, as well as with alcohol. "It's a good pick-me-up," the 20-year-old said. "(But) I'll think about it more now." The North Shore resident said he hasn't had any negative side effects, although his heart raced after drinking it. "But that's the whole thing, it's meant to do that," he said.
Red Bull refused to comment yesterday.
15 August, 2008
Vengeful Australian drugs regulator costs taxpayers $55 million
The TGA does not like alternative medicines generally and they were particularly cheesed with this guy because they had lost previous legal battles with him. So they used faults in a few of his products as an excuse to shut down his entire business -- even though there was no evidence of problems with over 200 other products. The fact that they had been too lazy to do any inspections in response to earlier complaints would also have counted against the TGA. The big damages payout is clear evidence that the TGA is a typical bureaucracy: At once lazy and irresponsible in the use of its powers. Since they control all access to drugs in Australia, new and less capricious management for them would seem urgent
The former chief executive of Pan Pharmaceuticals will get $55 million in compensation from the Commonwealth government, after the Federal Court found a government agency had been negligent. Jim Selim was the chief executive of Pan Pharmaceuticals, which went into liquidation in 2005, owing some $180 million after faulty batches of its travel sickness remedy Travacalm resulted in at least 87 adverse reactions and 19 hospitalisations. Symptoms included psychotic episodes, hallucinations and blackouts.
The Therapeutic Goods Administration (TGA) suspended Pan's licence and ordered the immediate withdrawal of 219 of its products. After Pan pleaded guilty to 24 charges relating to defective medication, Mr Selim launched legal action, claiming the TGA had pursued a vendetta against him and Pan.
Today, Justice Arthur Emmett congratulated legal counsel for reaching a settlement in a case he said could have continued for several more weeks. "I see no reason why the court shouldn't act in accordance with the wishes of the parties,'' Judge Emmett said. He made an order confirming the settlement, which will see $50 million compensation paid by the Commonwealth to Mr Selim and an extra $5 million for legal costs, to be paid within 28 days.
Outside the court, Mr Selim said he was thankful for the result but he was still waiting for a public apology from the TGA for its actions, which he said had come at great personal cost to himself.
Source. More background here
The Pill may put you off smell of your man and ruin your relationship. An update
To millions of women it has been the great liberator over the past four decades, allowing them the freedom to control their fertility and their relationships. But the contraceptive Pill could also be responsible for skewing their hormones and attracting them to the "wrong" partner. A study by British scientists suggests that taking the Pill can change a woman's taste in men - to those who are genetically less compatible.
The research found that the Pill can alter the type of male scent that women find most attractive, which may in turn affect the kind of men they choose as partners. It suggests that the popular form of contraception - used by a quarter of British women aged between 16 and 50 - could have implications for fertility and relationship breakdowns.
The findings, from a team at the University of Liverpool, add to growing evidence that the hormones in the Pill influence the way that women assess male sexual attractiveness. The Pill is thought to disrupt an instinctive mechanism that brings together people with complementary genes and immune systems. Such a couple, by passing on a wide-ranging set of immune system genes, increase their chances of having a healthy child that is not vulnerable to infection. Couples with different genes are also less likely to experience fertility problems or miscarriages. Experts believe that women are naturally attracted to men with immune system genes different to their own because of their smell.
Commenting on the latest study, the researchers said that it could indicate that the Pill disrupts women's ability to judge the genetic compatibility of men by means of their smell. They said that this might not only impact on fertility and miscarriage risk, but could even contribute to the end of relationships as women who stop or start taking the Pill no longer find their boyfriend or husband so attractive.
Several previous studies have suggested that women tend to prefer the smell of men who are different from them in a cluster of genes called the major histocompatibility complex (MHC), which governs the immune system. Some of these studies have also found that this effect is not seen among Pill users.
The latest study, published in the journal Proceedings of the Royal Society, has now assessed the impact of Pill use in the same women, both before and after they began using oral contraception. A group of 97 women was tested, some of whom started taking the Pill during the course of the research. All had their MHC genes tested and were asked to sniff T-shirts worn in bed by men with different patterns of MHC genes.
Unlike some previous studies, the research did not find any preference for dissimilar MHC genes. However, when the women started taking the Pill their preferences shifted towards the scent of men with more similar genes to their own. This suggests that Pill use has an effect on perceptions of scent attractiveness, even if there is no underlying female preference for similar or dissimilar MHC genes.
Craig Roberts, who led the study, said: "The results showed that the preferences of women who began using the Pill shifted towards men with genetically similar odours. Not only could MHC-similarity in couples lead to fertility problems, but it could ultimately lead to the breakdown of relationships when women stop using the Pill, as odour perception plays a significant role in maintaining attraction to partners."
The research also found differences between women in relationships, who tended to prefer odours of men with different MHC genes, and single women, who tended to prefer the smell of MHC-similar men. This could potentially indicate that if women are tempted to have an affair, they are more likely to choose a man with very different genes, to maximise the diversity of any offspring that they might have.
The scientists said that more work was needed to explain the way various studies have obtained different results on whether women naturally prefer men with different or similar MHC genes. They also cautioned that the importance of scent in human mating preferences remains uncertain.
The research backs up an earlier study of how women's perceptions of partners can alter when taking the Pill. Psychologists from St Andrews and Stirling universities found that women on the Pill tend to prefer macho types with strong jaw lines and prominent cheekbones. However, women who are not taking that form of contraception seem to be more likely to go for more sensitive types of men without traditionally masculine features.
Improved IVF process
A couple have become the first in Britain to have a baby using a new fertility technique, after seven years of trying to become parents. Evie Bloomer was conceived using vitrification - a method of embryo storage that has a higher success rate than the standard slow-freezing process. Her parents, Ian and Rebecca, from Cwmbran, South Wales, have been trying for a baby since marrying in 2001. Mrs Bloomer, 28, suffers endometriosis, a condition in which womb tissue grows elsewhere in the abdomen.
Evie's birth is a landmark because vitrification could deliver substantial improvements in fertility treatment. Embryo freezing allows parents to store surplus embryos should the first cycle fail, or to try for further children later on. The first such baby was born in the United States in 1984 and thousands have since been born in Britain.
But only 50-80 per cent of frozen embryos survive the thawing process because of ice crystals, which can cause fatal damage. Vitrification is an improved method by which embryos are flash-frozen in liquid nitrogen, together with an antifreeze. Around 98 per cent of embryos frozen this way survive thawing. Lyndon Miles, head of embryology and andrology at IVF Wales, who treated the Bloomers, said that a vitrification programme started in August last year was already delivering very promising results. Of 39 couples treated so far, 17 have had a pregnancy and the success rate of 43.5 per cent is more than double the 21 per cent that the clinic has achieved with slow-frozen embryos.
Dr Miles said wider use of vitrification could help the Human Fertilisation and Embryology Authority to persuade more couples to use just one embryo in IVF treatment, potentially cutting the multiple birthrate from one in four to one in ten. "If you are going to have single embryo transfer, your embryo freezing programme has to be very good so you have embryos available as a back-up," he said.
"Though this is a new technique for the UK, early results and publications in Japan and the USA have been extremely encouraging. The first published study on babies born from vitrification shows no adverse effects and there are no implications to Evie's health as a result of the process."
14 August, 2008
Are you eating arsenic with your picnic?
The article below from an Australian sociologist shows some restraint but omits entirely to note the central truth of toxicology: That the harm lies in the dose. The amount of arsenic ingested under the circumstances concerned would be extremely small. For context, note that arsenic was up until not long ago widely used in medicines, so its toxicity results only from a fairly HIGH dose.
The article also makes no mention of why CCA treatment is done. Could it be a scheme by evil businessmen? No: "Wood, such as radiata pine, is treated with CCA to prolong its life. CCA is used for the `control and prevention of damage to timber and timber structures by insects, wood rot, wood fungus and general timber decay. CCA is generally used on wood intended for outdoor uses, such as telegraph poles, decking and fencing, in landscaping, and in building structures'. It is also commonly used in playgrounds, children's cubby houses, public picnic tables, garden edgings, handrails, boat bulkheads, dock pilings and vineyard stakes. CCA-treated timber can often be identified when it is new by its green tinge but this fades with time"
So it would be costly to cease such treatment and would require a lot more trees to be felled in order to replace the timber more frequently
They're panicking in Indiana, US. When TV news show 13 Investigates tested the surface of picnic tables there recently, it found high levels of arsenic. Now, thousands of picnic tables are being removed from parks or painted with an oil-based stain. The picnic tables are made of timber treated with copper chrome arsenate (CCA), used in most of Australia's park picnic tables. Should we also be panicking?
Scientists have demonstrated that arsenic leaks out of CCA-treated timber, even 20 years after it has been treated. It is also known that exposure to arsenic can cause cancer. According to the World Health Organisation [A UN body and a prolific fountain of nonsense], arsenic is a known carcinogen and is acutely toxic. It can cause lung, bladder and skin cancer, as well as reproductive and neurological problems.
But is there enough arsenic in Australian picnic tables to cause such dire consequences? We don't really know because no one has done wipe tests. Without such data, and given the high levels of arsenic found by such studies overseas, can we be complacent about the risks involved? Some nations have taken a precautionary approach. CCA-treated timber has been banned altogether in Switzerland, Vietnam and Indonesia and severely restricted in Japan and Europe. In 2005 the Australian Pesticides and Veterinary Medicines Authority cancelled the use of CCA for treating timber destined for garden furniture, picnic tables, exterior seating, children's play equipment, patio and domestic decking and handrails.
But should we be worried about the picnic tables (and play equipment) already out there in our parks and on our beaches? Should our councils be allowing parents and children to eat food off treated timber picnic tables that could be coated in arsenic? People can be exposed to arsenic through touching CCA-treated timber because surface arsenic sticks to human skin. It then can be transferred to the mouth, for example by subsequent handling of food. It also can be transferred to the mouth by eating food placed directly on CCA-treated surfaces.
Yet how many people think twice about eating off council picnic tables? Surely that is what they are there for? The APVMA claims it has no power to control how people use the structures made from CCA-treated timber. It is local councils that control the ongoing use of existing picnic tables. Local councils may be comforted by the fact that picnic tables have been around for many years and no one has yet set out to prove that they got cancer from them.
But who would dream that their lung or bladder or skin cancer might have been caused by eating off picnic tables in their youth? Especially given that Australian authorities didn't admit to the potential problem until recently. The lack of past lawsuits will not provide comfort to the wider community. Perhaps only tests showing picnic tables are arsenic-free will do that. Otherwise there might be good reason to follow Indiana park authorities and do something about all those picnic tables.
New pill to offer respite from the common cold
A PILL to cure the common cold has been developed by scientists. The holy grail of cold research, it could be used to clear up sniffles in healthy people and prevent life-threatening infections in asthma and cystic fibrosis sufferers. Trials on hundreds of British volunteers started yesterday. If successful, the cold-busting pill could be on the market in five years. Effective against the bugs that cause half of colds in adults and almost all colds in children, it could net its Australian creators billions of dollars a year.
The drug, which is known as BTA798, latches on to cold-causing human rhinoviruses (HRV), preventing them breaking into the body's cells and causing infection. In a double-pronged attack, it also stops any infection that has taken hold from spreading. In lab tests, the drug killed large quantities of cold virus within a couple of hours. The first limited human trials finished last year and showed BTA798, which is being developed by the Victoria-based Biota Holdings, to be safe.
Peter Cook, the company's chief executive officer, hailed the results as a significant milestone in the development of what could be a world-first anti-viral treatment for HRV in high-risk patients. Larger-scale trials are now under way to determine whether it can actually prevent people from catching a cold. Two hundred healthy people will be given the drug or a dummy pill before being exposed to human rhinovirus. Three different doses of the drug will be used, in order to determine which, if any, can keep the infection at bay.
13 August, 2008
BOOK REVIEW of Hyping Health Risks By Geoffrey C. Kabat
Review By RONALD BAILEY
Does the wearing of shoes with heels cause schizophrenia? That was the contention made in 2004 by a Swedish physician in Medical Hypotheses, a scientific journal that specializes in out-of-the-box thinking. "Heeled footwear," the physician observed, "began to be used more than 1,000 years ago, and led to the occurrence of the first cases of schizophrenia." As heeled shoes sprinted across the world, he said, so did the incidence of the disease. He called for epidemiological studies to check his hypothesis.
It is possible that some epidemiologist somewhere is crunching heeled-shoe data and preparing a paper on the subject. And if such a paper appears, the media will treat it with sober regard -- assuming that it confirms the doctor's wild idea. A Nexis survey of newspaper headlines from the past week finds epidemiological studies playing a role in all sorts of claims: that sleep apnea increases the risk of early death; that thunderstorms provoke asthma attacks; that cellphones might cause cancer; that flu shots may not help the elderly; that consuming fruit drinks increases the risk of diabetes in women. Some of these reports may turn out to be important but most will amount to a kind of scientific noise, adding to our uneasy sense that, in the modern world, danger lurks on every side.
In "Hyping Health Risks," Geoffrey Kabat, an epidemiologist himself, shows how activists, regulators and scientists distort or magnify minuscule environmental risks. He duly notes the accomplishments of epidemiology, such as uncovering the risks of tobacco smoking and the dangers of exposure to vinyl chloride and asbestos. And he acknowledges that industry has attempted to manipulate science. But he is concerned about a less reported problem: "The highly charged climate surrounding environmental health risks can create powerful pressure for scientists to conform and to fall into line with a particular position."
Mr. Kabat looks at four claims -- those trying to link cancer to man-made chemicals, electromagnetic fields and radon and to link cancer and heart disease to passive smoking. In each, he finds more bias than biology -- until further research, years later, corrects exaggeration or error.
In the 1980s, some women on Long Island thought they noted a high incidence of breast cancer in their community and charged that man-made chemicals were to blame. In 1993, a tiny, overhyped study, examining the blood of Long Island women, announced that it had found a strong association between DDE, a metabolic molecule derived from the pesticide DDT, and breast cancer. Alarmed activists persuaded Congress to fund a massive epidemiological study devoted to the causes of breast cancer among women on Long Island.
In 2002, the Long Island study found no association between cancer and blood levels of DDE or other synthetic chemicals, including PCBs. That same year the American Cancer Society reported that 22 studies could find no association between breast cancer and compounds like DDE and PCBs. "The politicization of breast cancer," Mr. Kabat notes, "led initially to the carrying out of the studies based on weak hypotheses and inadequate methods, which were greatly oversold."
In 1979, a small study suggested that electromagnetic fields (EMF) from power lines and home appliances might cause cancer, especially in children. In 1989, Paul Brodeur played up these findings in the New Yorker and charged industry with a coverup. Mr. Kabat explains in detail how several epidemiologists slanted their studies so that, he believes, they could justify further funding for their EMF research. Indeed, epidemiologists kept torturing weak data with sophisticated statistical techniques, trying to force electromagnetic fields to confess to murder. They never did. Physicists eventually showed the biological implausibility of the EMF claim. One physicist, Mr. Kabat says, "likened concern over weak EMF from power lines to the fear that leaves falling from trees could fracture a person's skull."
In the 1990s, EPA regulators were eager to charge that residential exposure to radon -- a gas that arises naturally from certain geological formations -- was a major cause of lung cancer. They pointed to several studies to make the case and proposed a host of expensive regulations. It turned out that 90% of the lung cancer that the EPA's studies attributed to radon was actually associated with cigarette smoking.
Finally, Mr. Kabat takes up the vexed case of passive smoking. He shows how anti-smoking activists, in collusion with EPA regulators, steam-rolled over evidence that passive smoke is a very minor cause of chronic lung disease. An irritant, yes, but a death sentence for bystanders, no. The EPA's 1992 meta-analysis -- the source for anti-smoking regulations ever since -- simply tossed out studies that failed to show an association between cancer and passive smoking.
I know whereof Mr. Kabat speaks. In 1992, as the producer of a PBS program, I interviewed an epidemiologist who was on the EPA's passive-smoking scientific advisory board. He admitted to me that the EPA had put its thumb on the evidentiary scales to come to its conclusion. He had lent his name to this process because, he said, he wanted "to remain relevant to the policy process." Naturally, he didn't want to appear on TV contradicting the EPA.
Mr. Kabat himself got burned by activist fury when, in 2003, he and a colleague published a study using 40 years of American Cancer Society data. The study found "no evidence of an elevated risk of coronary heart disease or lung cancer" in the nonsmoking spouses of smokers. Activists attacked the study before publication by saying that Mr. Kabat had been funded by tobacco money. In fact, only the last seven years of data collection had been funded by a research center supported largely by tobacco companies. Mr. Kabat was not prepared for this kind of scientifically irrelevant and dishonest assault. But some good came of it: It provoked him to write this book.
Breakthrough curbs cancer cells
Australian scientists are hoping to cure leukaemia, asthma and rheumatoid arthritis after their breakthrough discovery of how to stop killer blood cells growing. The team has unlocked the secrets behind the protein which controls the way the blood cancer cells spread when it is damaged - and have found a way to stop its deadly process.
Work is now starting to design a drug to prevent the damaged proteins operating, effectively stopping the cancer as well as asthma and inflammatory diseases such as rheumatoid arthritis.
After spending a decade uncovering the structure of the receptor protein, which sits on the surface of white blood cells, lead researcher Professor Michael Parker, of Melbourne's St Vincent's Institute, said scientists could now build a drug to attach itself to the protein and stop it sending messages into the cells telling them to multiply unchecked. "If we can stop the signal for the proliferation of uncontrolled growth of the cells then we can stop the leukaemia in its tracks," he said.
Working with molecular biologists at Adelaide's Hanson Institute, the Melbourne scientists used X-ray and synchrotron imaging to build an image of the structure of the protein for the first time, hoping to find a way to block its process. The GM-CSF hormone - which controls the production of blood cells in the body - works by attaching itself to the receptor proteins, which then send a message into white blood cells telling them to multiply. When damaged, the protein's messages cause an over-production of cells or cells which persist too long, resulting in diseases such as leukaemia as well as some inflammatory conditions.
The major breakthrough came when the researchers realised the proteins linked together to form networks on the surface of white blood cells after being activated by the hormone, and that by stopping the networks forming they could also stop the growth.
While the drug development phase has only just begun, Professor Parker said it would be easier to target a protein on the surface of the cell rather than trying to come up with a molecule to break its way into the centre of the cell.
12 August, 2008
Medical breakthrough? Lettuce, tobacco and diabetes
This story has been around for a while. I must say I do not understand the logic of it. But in vivo trials have apparently been successful
Capsules of insulin produced in genetically modified lettuce could hold the key to restoring the body’s ability to produce insulin and help millions of Americans who suffer from insulin-dependent diabetes, according to University of Central Florida biomedical researchers. Professor Henry Daniell’s research team genetically engineered tobacco plants with the insulin gene and then administered freeze-dried plant cells to five-week-old diabetic mice as a powder for eight weeks. By the end of the study, the diabetic mice had normal blood and urine sugar levels, and their cells were producing normal levels of insulin.
Those results and prior research indicate that insulin capsules could someday be used to prevent diabetes before symptoms appear and treat the disease in its later stages, Daniell said. He has since proposed using lettuce instead of tobacco to produce the insulin because that crop can be produced cheaply and avoids the negative stigma associated with tobacco. The National Institutes of Health provided $2 million to fund the UCF study. The findings are reported in the July issue of Plant Biotechnology Journal.
Insulin-dependent, or Type 1, diabetes is an autoimmune disease in which the body’s immune system attacks and destroys insulin and insulin-producing beta cells in the pancreas. Insulin is a hormone that is needed to convert sugar, starches and other food into energy.
Insulin typically is given through shots and not pills so the hormone can go straight into the bloodstream. In Daniell’s method, plant cell walls made of cellulose initially prevent insulin from degrading. When the plant cells containing insulin reach the intestine, bacteria living there begin to slowly break down the cell walls and gradually release insulin into the bloodstream. “Currently, the only relief for diabetes is a momentary relief,” Daniell said. “Diabetics still have to monitor their blood and urine sugar levels. They have to inject themselves with insulin several times a day. Having a permanent solution for this, I’m sure, would be pretty exciting.”
Though produced in lettuce, the insulin would be delivered to human patients as a powder in capsules because the dosage must be controlled carefully. If human trials are successful, the impact of Daniell’s research could affect millions of diabetics worldwide and dramatically reduce the costs of fighting a disease that can lead to heart and kidney diseases and blindness. About 20.8 million children and adults in the United States, or about 7 percent of the population, have Type 1 or 2 diabetes, according to the American Diabetes Association.
Daniell’s method of growing insulin in plants is similar to what he used for an earlier study to produce anthrax vaccine in tobacco. In the earlier study, which also involved mice, Daniell showed and the National Institutes of Health confirmed that enough safe anthrax vaccine to inoculate everyone in the United States could be grown inexpensively in only one acre of tobacco plants
Source. A more recent report here
Preferences genetically encoded in the brain
A team of researchers from Massachusetts General Hospital (MGH) has used brain imaging, genetics and experimental psychology techniques to identify a connection between brain reward circuitry, a behavioral measurement of preference and a gene variant that appears to influence both. The report in the August 4 issue of Archives of General Psychiatry describes how variations in a gene involved with the brain's reward function are associated with the activity of a key brain structure and, in parallel, with the effort study participants 'invest' in viewing emotion-laden facial images. The findings have implications for how genes may influence healthy or dysfunctional behavior involving choices in many different areas.
"This work helps connect our psychological understanding of why we like some things and not others with the genetic mechanisms that define our range of behaviors," says Hans Breiter, MD, senior and corresponding author of the study and principal investigator for the Phenotype Genotype Project in Addiction and Mood Disorders, an interdisciplinary project involving the MGH Departments of Radiology, Psychiatry, and Neurology. "In the ongoing discussion about how much the environment versus genetics determine behavior, this study points to how the interaction between these factors influences our judgment and decision-making."
The current study is part of a decade-long effort to link studies of reward and aversion in animal models to human psychology and neuroscience. In the mid-1990s, Breiter and other MGH researchers used functional magnetic resonance imaging (fMRI) techniques to demonstrate how structures deep within the brain were involved with the experience of reward, how that experience was connected to motivated behavior, and how the reward system could be co-opted in situations like drug addiction.
In 2001, Breiter collaborated with Daniel Kahneman, PhD, of Princeton University and Peter Shizgal, PhD, Concordia University, Montreal, to show how the brain's reward/aversion circuitry followed the principles of what is called prospect theory when responding to the anticipation and receipt of a financial reward, helping to lay the groundwork for the field now called neuroeconomics. Kahnemann was a co-recipient of the 2002 Nobel Prize in economics for his earlier development of prospect theory, which describes the different ways people evaluate positive and negative outcomes in uncertain situations.
The current report connects molecular genetics with earlier studies of choice and preference and with investigations of the brain's reward circuitry. The researchers focused on a gene called CREB1 that has been implicated in animal studies of the brain's reward/aversion function. Study lead author Roy Perlis, MD, medical director of the MGH Bipolar Program, and colleagues previously found that depressed men with a particular variation near the gene coding for CREB report greater difficulty suppressing anger. Another study of theirs associated the same variation with a threefold greater risk of suicidal thinking in major depressive disorder patients soon after beginning antidepressant therapy. The 28 participants in the current study had no evidence of any psychiatric disorder or physical disorder that might influence brain activity.
In addition to analyzing each participant's version of the CREB1 gene, the researchers conducted a set of experiments. As the participants viewed facial expressions reflecting different emotional states - happy, neutral, sad, fearful and angry - fMRI scans were taken to examine the activity of brain structures associated with processing pleasant or unpleasant experiences. In another test, participants viewed the same pictures and could change how long they viewed an image by the way they pressed keys on a keyboard. Many earlier studies have established the keypress experiment as a quantitative measure of preference. In the version used in this study, keypress responses reflected participants' judgment and decisions about how much or how little they preferred the facial expressions.
The fMRI study showed that, during the viewing of angry faces, the activity of a structure called the insula, involved in the response to unpleasant situations, depended on which version of the CREB1 gene a participant inherited. In the keypress experiment, responses indicating a preference against the angry expression paralleled the CREB1-affected fMRI activity seen in the insula in the first experiment and also differed depending on the CREB1 variant that had been inherited.
"We were surprised to see that variation in the CREB1 gene would account for more than 20 percent of the difference in how healthy participants weighed different options and expressed specific preferences," says Perlis. "Our previous studies and the work of other groups suggested that variation in this gene could be important for judgment and decision-making by the brain, but we needed to connect this to a measurable decision-making effect in both behavior and brain activity."
Breiter adds, "This study connects quantitative measurements across three levels of observation - brain activity, genomic variation and the expression of preference. We now are investigating the potential role of other genes and will go on to assess how this relationship across three levels of observation may be affected by conditions such as depression and addiction."
11 August, 2008
Stepdads 'make better fathers'
The secrecy about race that prevails in so many American publications can be DAMNED annoying. It is absolutely notorious that black inner city U.S. males are overwhelmingly "absent" fathers -- vastly more so than whites. Yet this study says absolutely nothing about the race of those surveyed. For those used to the primness of the American intelligentsia, however, the following sentence gives a large clue: "The Fragile Families and Child Wellbeing Study is following a cohort of nearly 5,000 children born in large U.S. cities between 1998 and 2000 (roughly three-quarters of whom were born to unmarried parents)." Most of the participants (if not all) would have been black. Given the known black/white differences, therefore, there is NO reason to generalize these finding to whites. Race matters and racial differences cannot be made to go away by closing your eyes to them
STEPFATHERS make better parents than biological dads, a controversial study has found. In a finding that is certain to spark rigorous debate, stepfathers were found to be "more engaged, more co-operative and shared more responsibility than their biological counterparts did". The US study contradicts a popular view among social workers and family experts that biological fathers invest more in their own flesh and blood.
Sydney psychologist Grant Brecht said that, while the results of the study certainly apply to "some stepfathers", it was wrong to generalise. "There is no reason why stepfathers cannot make incredibly good parents and they may be more attentive," Mr Brecht said. "But I think you have to look at it case by case."
The findings were drawn from 2098 interviews with urban mothers from the Fragile Families And Child Wellbeing study. The children, born from 1998 to 2000, were aged five at the time of the last interviews.
Mothers reported that stepfathers shared their parenting views and talked to them more about their parental wants than natural fathers did, said the study's author, Lawrence Berger of the University of Wisconsin-Madison. "(Stepfathers) have to work harder to fit in and to have a useful productive role," psychologist Rebekah Levine Coley said.
Australia: Kids defy food fanatics
Children are defying a junk-food ban in school canteens by smuggling in fattening snacks and selling them to classmates. Frustrated teachers reveal they are powerless to stop many children who bring unhealthy treats from home in their bags. ``I've even seen them selling chocolates to their classmates at school. It's almost like they're dealing drugs,'' said a teacher from a prominent Perth southern suburbs public school.
Education Minister Mark McGowan conceded he could not halt the junk-food flood, even though the Government stopped it from being sold in canteens last year. ``What students bring to school in their lunchboxes is not covered by the canteen policy,'' he said. ``And we can't police what foods children bring to school. If teachers notice a particular child selling junk food on the side, I encourage them to alert the school principal. ``We as a Government can only do so much. It is important parents keep a close eye on their child or children to make sure they are doing the right thing.''
Obesity was a serious issue, which was why the Carpenter Government required all public school canteens or food services to have healthy menus, Mr McGowan said. A healthy canteen menu, combined with the required two hours of exercise a week for Years One to 10, were great initiatives. ``But parents also need to come on board in the fight against obesity. This is not the sole responsibility of the Government,'' he said.
Rob Fry, president of peak parent group the WA Council of State School Organisations, said parents should realise they were ``killing their kids'' with bad food. They should pack healthy lunches, or pre-pay for canteen meals, so children had no cash for junk.
WA State School Teachers Union general secretary David Kelly said teachers could contact parents if they were concerned about certain students. But parents and schools had to work together to address obesity. The southern suburbs teacher said: ``When they banned junk food from canteens it came back into school with a vengeance. They just started bringing their own from home, like chips and chocolates. ``I'd love to be able to confiscate it. But we're not allowed to take food off kids because they can just say `mum gave me this for lunch'.''
Another southern suburbs teacher said: ``Most teachers I know are all for the ban. But there's no use having a ban if you can't stop them from bringing it to school. ``Some kids are selling it to their mates, which would be funny if our kids weren't so fat. ``But you can't really say anything to your students these days. They swear at us in the classroom and get away with it, so this would be hard to stop.''
Another teacher said healthy canteen food had great potential to help children who weren't getting good food at home and it was a pity the situation had deteriorated to this. Canteens have a ``traffic light'' system banning ``red'' items such as soft drinks, confectionery, deep-fried foods, chips, chocolate coated ice-creams and cakes. [All of which are completely harmless -- or we would all be dead]
10 August, 2008
Prostate screening dubious
Doctors should stop routine prostate cancer screening of men over 75 because there is more evidence of harm than benefit, a federal task force advised Monday in a new blow to a much scrutinized medical test. The U.S. Preventive Services Task Force, which made the recommendation, reported finding evidence that the benefits of treatment based on routine screening of this age group "are small to none." However, treatment often causes "moderate-to-substantial harms," including erectile dysfunction and bladder control and bowel problems, the task force said.
The new guidance is the first update by the task force on prostate cancer screening since 2002. The last report on the subject from this panel of experts, which sets the nation's primary care standards, concluded there was insufficient evidence to recommend prostate screening for men of all ages.
In recent years, there has been a growing debate about the value of the somewhat imprecise PSA test to detect cancer, as well as the value of treating most prostate cancers. A number of experts contend patients are being overtreated. Most major U.S. medical groups recommend doctors discuss the potential benefits and known harms of prostate screening with their patients and make individual decisions. And most agree such testing shouldn't occur before age 50.
The federal task force reviewed past research in reaching its conclusion and "could not find adequate proof that early detection leads to fewer men dying of the disease," task force chairman Dr. Ned Calonge of Denver, said in a statement.
Prostate cancer is the most common cancer in American men -- about 220,000 cases will be diagnosed this year. It is the second leading cause of cancer deaths in men. But most tumors grow so slowly they never threaten lives. There is no accurate way to tell which tumors will.
Earlier this year, a study found that older men who already had early-stage prostate cancer were not taking a big risk by not treating it right away. The vast majority were alive 10 years later without significantly worrying symptoms or had died of other causes.
Prostate cancer treatments are tough, especially on older men. Some doctors instead recommend "watchful waiting" to monitor signs of the disease and treat only if they worsen, but smaller studies give conflicting views of the safety of that approach. The new guidelines from the Preventive Services Task Force were published in this month's Annals of Internal Medicine.
Study Confirms Abortion Increases Risk of Depression
I would be surprised if it were otherwise. It goes against every motherly instinct
A 2008 study by the University of Oslo in Norway has found that young adult women who have had abortions are more likely to become depressed. The study, which involved 768 women between the ages of 15 and 27, was carried out in order to "investigate whether induced abortion was a risk factor for subsequent depression."
According to Willy Pedersen from the University's Department of Sociology and Human Geography, who conducted the study, past studies have suffered in accuracy due to bad design, specifically a lack of control of "compounding factors."
The new study strove to prevent this problem by creating a comprehensive list of factors to question women on, including, "depression, induced abortion and childbirth, as well as sociodemographic variables, family relationships and a number of individual characteristics, such as schooling and occupational history and conduct problems."
Women in the sample who had abortions while in their twenties were "more likely to score above the cut-off point for depression," and although the likelihood was reduced when the compounding factors were accounted for, their propensity to become depressed "remained significant." The study concluded that, "Young adult women who undergo induced abortion may be at increased risk for subsequent depression."
9 August, 2008
Common fertility treatments are 'no better than nature', study finds
Once again, conventional medical wisdom fails under test
Fertility treatments offered to couples trying for a baby are no more effective than attempts to conceive naturally, a study suggests today. Couples who attempt artificial insemination or use a drug designed to aid conception do not have significantly higher chances of a pregnancy than those not receiving treatment, the researchers found.
One in seven couples in Britain experiences problems conceiving, with about a quarter of these having unexplained infertility. Treatments are offered in line with fertility guidelines issued by the National Institute for Health and Clinical Excellence (NICE). They include artificial insemination, and the drug clomiphene citrate, which is believed to correct subtle ovulatory dysfunction. Such treatments are relatively inexpensive and do not involve stimulation of a woman's ovaries or IVF (in vitro fertilisation).
Researchers writing in the British Medical Journal, however, have thrown into question the provision of such treatments on the NHS. Intrauterine insemination (IUI) and clomiphene citrate (Clomifert or Clomid) are recommended for couples who have had difficulty conceiving, but where investigations have failed to find out why. Couples would typically be offered these methods before considering IVF, which involves collecting a woman's eggs, fertilising them outside the body and returning them to her womb.
For the study, 580 women who had been trying unsuccessfully to conceive for more than two years were recruited from four teaching hospitals and one general hospital in Scotland. One group of 193 women were given advice on having sex regularly but were left to try to conceive naturally. Another 194 women were given clomifene. The remaining 193 were given IUI, which is thought to enhance the chance of pregnancy by injecting sperm behind the cervical barrier. All treatments were followed for six months.
At the end of the study, there had been 101 live births - 32 among the 193 women trying to conceive naturally (17 per cent), 26 among those on the drug (14 per cent) and 43 among those having insemination (23 per cent). The researchers, from the universities of Aberdeen and Oxford, and hospitals in Edinburgh, Dundee, Falkirk and Glasgow, said that these differences were not significant enough to be attributed solely to treatment or lack of it. They suggested that the NHS could be wasting time and money on providing the therapies and called for the NICE guidelines to be reviewed.
Siladitya Bhattacharya, Professor of Reproductive Medicine in Aberdeen, who led the study, said that it was difficult to estimate how many women currently used IUI or clomifene citrate treatments, but added that it must be "hundreds of thousands".
NICE endorses the use of up to six free cycles of IUI without ovarian stimulation in couples with unexplained infertility. Thousands of couples are being denied the three free cycles of IVF recommended by NICE as an advanced treatment, largely because of the expense. Figures from the Department of Health showed in June that nine out of 151 primary care trusts in England provided three cycles of IVF, leaving many patients to pay up to $4,000 per cycle for private treatment.
NICE said that the fertility guidance published in 2004 set "clear standards by outlining which types of treatment offer couples the best chance of conceiving, based on the best available evidence from around the world".
Source. Another account of the above findings here.
Researchers Say Antibiotic From Maggots May Kill MRSA
British researchers said Tuesday they've developed an antibiotic from maggots that can be used to fight different kinds of bacteria including certain strains of deadly methicillin-resistant Staphylococcus aureus. The team from Swansea University in south Wales has developed a drug called Seraticin, which is made from the secretions of green bottle fly larvae, Agence France-Presse reported. The researchers are hoping to turn the antibiotic into a drug that can be injected, swallowed as a pill or used as an ointment.
More than 90,000 Americans get MRSA infections each year, according to a study released by the government last October. Medical and government experts worry annual deaths from the drug-resistant "superbug" may soon exceed deaths from AIDS.
MRSA bacteria can be carried by healthy people, living on their skin or in their noses. Most infections occur in hospitals. However, in recent years, the bug has invaded schools, locker rooms and fitness centers.
8 August, 2008
Vitamin C slows cancer in mice
Oxygen for the vitamin C freaks. If you do enough studies, one will come "right" by chance alone. Pesky that you've got to inject it rather than eat it, though
HIGH doses of vitamin C injections reduced the size of tumours and slowed cancerous growths by about 50 per cent in laboratory mice, according to US research released today. Researchers at the National Institutes of Health noted the phenomenon in brain, ovarian and pancreatic cancers, according to findings published in the August 5 issue of the Proceedings of the National Academy of Sciences.
"Researchers discovered that high concentrations of ascorbate had anticancer effects in 75 per cent of cancer cell lines tested, while sparing normal cells," the report said. "The researchers traced ascorbate's anti-cancer effect to the formation of hydrogen peroxide in the extracellular fluid surrounding the tumours. Normal cells were unaffected," it said. Injections were necessary because the body regulates vitamin C when ingested, so that higher doses cannot be attained.
"When you eat foods containing more than 200 milligrams of vitamin C a day - for example, two oranges and a serving of broccoli - your body prevents blood levels of ascorbate from exceeding a narrow range," said Mark Levine, the study's lead author and chief of the Molecular and Clinical Nutrition Section of the National Institute of Diabetes and Digestive and Kidney Diseases.
Scientists "injected ascorbate into the veins or abdominal cavities of rodents with aggressive brain, ovarian, and pancreatic tumours", the report said, delivering "up to four grams per kilogram of body weight daily". By injecting mice with 43 cancer and five normal cell lines, "the researchers discovered that high concentrations of ascorbate had anticancer effects in 75 per cent of cancer cell lines tested, while sparing normal cells."
Scientists involved with the study also pointed to evidence that "these high ascorbate concentrations could be achieved in people." "In immune-deficient mice with rapidly spreading ovarian, pancreatic, and glioblastoma (brain) tumours ... the ascorbate injections reduced tumour growth and weight by 41 to 53 per cent."
The researchers concluded that the findings "provide the first firm basis for advancing pharmacologic ascorbate in cancer treatment in humans." Vitamin C was considered as a possible treatment for cancer three decades ago, but subsequent studies showed oral doses provided no benefit.
High-Aptitude Minds: The Neurological Roots of Genius
Researchers are finding clues to the basis of IQ in the brain and the article excerpted below is a surprisingly positive summary of the work -- surprising for SciAm. I have long been saying that high IQ is usually just one aspect of general biological good functioning and the work discussed below could also be seen as conducing to that conclusion
* Smarter brains tend to be bigger-at least in certain locations. Researchers have fingered parts of the parietal and frontal lobes as well as a structure called the anterior cingulate as important for superior cognition.
* Some studies suggest that the brains of brighter people use less energy to solve certain problems than those of people with lower aptitudes do. But under certain circumstances, scientists have also observed higher neuronal power consumption in individuals with superior mental capacities.
* People often overestimate the importance of intellectual ability. Practice and perseverance contribute more to accomplishment than being smart does.
Within hours of his demise in 1955, Albert Einstein's brain was salvaged, sliced into 240 pieces and stored in jars for safekeeping. Since then, researchers have weighed, measured and otherwise inspected these biological specimens of genius in hopes of uncovering clues to Einstein's spectacular intellect.
Their cerebral explorations are part of a century-long effort to uncover the neural basis of high intelligence or, in children, giftedness. Traditionally, 2 to 5 percent of kids qualify as gifted, with the top 2 percent scoring above 130 on an intelligence quotient (IQ) test. (The statistical average is 100. See the box on the opposite page.) A high IQ increases the probability of success in various academic areas. Children who are good at reading, writing or math also tend to be facile at the other two areas and to grow into adults who are skilled at diverse intellectual tasks [see "Solving the IQ Puzzle," by James R. Flynn; Scientific American Mind, October/November 2007].
Most studies show that smarter brains are typically bigger-at least in certain locations. Part of Einstein's parietal lobe (at the top of the head, behind the ears) was 15 percent wider than the same region was in 35 men of normal cognitive ability, according to a 1999 study by researchers at McMaster University in Ontario. This area is thought to be critical for visual and mathematical thinking. It is also within the constellation of brain regions fingered as important for superior cognition. These neural territories include parts of the parietal and frontal lobes as well as a structure called the anterior cingulate.
But the functional consequences of such enlargement are controversial. In 1883 English anthropologist and polymath Sir Francis Galton dubbed intelligence an inherited feature of an efficiently functioning central nervous system. Since then, neuroscientists have garnered support for this efficiency hypothesis using modern neuroimaging techniques. They found that the brains of brighter people use less energy to solve certain prob-lems than those of people with lower aptitudes do.
In other cases, scientists have observed higher neuronal power consumption in individuals with superior mental capacities. Musical prodigies may also sport an unusually energetic brain [see box on page 67]. That flurry of activity may occur when a task is unusually challenging, some researchers speculate, whereas a gifted mind might be more efficient only when it is pondering a relatively painless puzzle.
Despite the quest to unravel the roots of high IQ, researchers say that people often overestimate the significance of intellectual ability [see "Coaching the Gifted Child," by Christian Fischer]. Studies show that practice and perseverance contribute more to accomplishment than being smart does.
In humans, brain size correlates, albeit somewhat weakly, with intelligence, at least when researchers control for a person's sex (male brains are bigger) and age (older brains are smaller). Many modern studies have linked a larger brain, as measured by magnetic resonance imaging, to higher intellect, with total brain volume accounting for about 16 percent of the variance in IQ. But, as Einstein's brain illustrates, the size of some brain areas may matter for intelligence much more than that of others does.
In 2004 psychologist Richard J. Haier of the University of California, Irvine, and his colleagues reported evidence to support the notion that discrete brain regions mediate scholarly aptitude. Studying the brains of 47 adults, Haier's team found an association between the amount of gray matter (tissue containing the cell bodies of neurons) and higher IQ in 10 discrete regions, including three in the frontal lobe and two in the parietal lobe just behind it. Other scientists have also seen more white matter, which is made up of nerve axons (or fibers), in these same regions among people with higher IQs. The results point to a widely distributed-but discrete-neural basis of intelligence
The neural hubs of general intelligence may change with age. Among the younger adults in Haier's study-his subjects ranged in age from 18 to 84-IQ correlated with the size of brain regions near a central structure called the cingulate, which participates in various cognitive and emotional tasks. That result jibed with the findings, published a year earlier, of pediatric neurologist Marko Wilke, then at Cincinnati Children's Hospital Medical Center, and his colleagues. In its survey of 146 children ages five to 18 with a range of IQs, the Cincinnati group discovered a strong connection between IQ and gray matter volume in the cingulate but not in any other brain structure the researchers examined.
Scientists have identified other shifting neural patterns that could signal high IQ. In a 2006 study child psychiatrist Philip Shaw of the National Institute of Mental Health and his colleagues scanned the brains of 307 children of varying intelligence multiple times to determine the thickness of their cerebral cortex, the brain's exterior part. They discovered that academic prodigies younger than eight had an unusually thin cerebral cortex, which then thickened rapidly so that by late childhood it was chunkier than that of less clever kids. Consistent with other studies, that pattern was particularly pronounced in the frontal brain regions that govern rational thought processes.
The brain structures responsible for high IQ may vary by sex as well as by age. A recent study by Haier, for example, suggests that men and women achieve similar results on IQ tests with the aid of different brain regions. Thus, more than one type of brain architecture may underlie high aptitude.
Low Effort Required
Meanwhile researchers are debating the functional consequences of these structural findings. Over the years brain scientists have garnered evidence supporting the idea that high intelligence stems from faster information processing in the brain. Underlying such speed, some psychologists argue, is unusually efficient neural circuitry in the brains of gifted individuals.
Experimental psychologist Werner Krause, formerly at the University of Jena in Germany, for example, has proposed that the highly gifted solve puzzles more elegantly than other people do: they rapidly identify the key information in them and the best way to solve them. Such people thereby make optimal use of the brain's limited working memory, the short-term buffer that holds items just long enough for the mind to process them.
Starting in the late 1980s, Haier and his colleagues have gathered data that buttress this so-called efficiency hypothesis. The researchers used positron-emission tomography, which measures glucose metabolism of cells, to scan the brains of eight young men while they performed a nonverbal abstract reasoning task for half an hour. They found that the better an individual's performance on the task, the lower the metabolic rate in widespread areas of the brain, supporting the notion that efficient neural processing may underlie brilliance. And in the 1990s the same group observed the flip side of this phenomenon: higher glucose metabolism in the brains of a small group of subjects who had below-average IQs, suggesting that slower minds operate less economically.
More recently, in 2004 psychologist Aljoscha Neubauer of the University of Graz in Austria and his colleagues linked aptitude to diminished cortical activity after learning. The researchers used electroencephalography (EEG), a technique that detects electrical brain activity at precise time points using an array of electrodes affixed to the scalp, to monitor the brains of 27 individuals while they took two reasoning tests, one of them given before test-related training and the other after it. During the second test, frontal brain regions-many of which are involved in higher--order cognitive skills-were less active in the more intelligent individuals than in the less astute subjects. In fact, the higher a subject's mental ability, the bigger the dip in cortical activation between the pretraining and posttraining tests, suggesting that the brains of brighter individuals streamline the processing of new information faster than those of their less intelligent counterparts do.
7 August, 2008
Health nuts Slam Chain Restaurants for Unhealthy Kid-Meal Options
There is no basis for any of this in the double blind studies. It is all just attention-seeking behaviour based on epidemiological speculation. The "low-fat=good" claim embodied in it is KNOWN TO BE FALSE. See here, here and here. And calories are bad! How awful! All food contains calories. All that matters is how much you eat. You can eat moderately anywhere.
Parents looking for healthy meal choices for their children are likely to find slim pickings on the menus of the nation's top restaurant chains, according to a report released this week by a nonprofit public health group. Nearly every possible combination of the children's meals at Kentucky Fried Chicken, Taco Bell, Sonic, Jack in the Box and Chick-fil-A are too high in calories, the report by the Center for Science in the Public Interest said, the AP reports.
The report looked into the nutritional quality of kids' meals at 13 major restaurant chains. The center found 93% of 1,474 possible choices at the 13 chains exceed 430 calories - an amount that is one-third of what the National Institute of Medicine recommends that children ages four through eight should consume in a day. For example, Chili's Bar and Grill has 700 possible kids' meal combinations, but 658, or 94%, of those are too high in calories. While there are some healthy choices on restaurant menus, "parents have to navigate a minefield of calories, fat and salt to find them," the report said.
Subway's kids' meals came out the best among the chains examined in the report. Only six of 18 "Fresh Fit for Kids" meals - which include a mini-sub, juice box, and one of several healthful side items such as apple slices, raisins or yogurt - exceed the 430-calorie threshold. But Subway is the only chain that doesn't offer soft drinks with kids' meals, which helped lower the calorie count. The report notes that eating out now accounts for a third of children's daily caloric intake, twice the amount consumed away from home 30 years ago.
"Parents want to feed their children healthy meals, but America's chain restaurants are setting parents up to fail," CSPI nutrition policy director Margo G. Wootan said in a statement. "McDonald's, Burger King, KFC, and other chains are conditioning kids to expect burgers, fried chicken, pizza, French fries, macaroni and cheese, and soda in various combination at almost every lunch and dinner."
The report also found that 45% of children's meals exceed recommendations for saturated and trans fat, which can raise blood cholesterol levels and increase the risk of heart disease, and 86% of children's meals are high in sodium [By sodium they mean salt. Kids can and do die from the lack of it. See here and here. "Hyponatremic" means "not enough salt"]
More cellphone nonsense
Please put your cell phone in the "calm down" position. Dr. Ronald B. Herberman may or may not have been seeking international attention when he, as director of the University of Pittsburgh Cancer Institute, sent a memo to about 3,000 faculty and staff to limit their cell-phone use because of the possibility of a link to cancer. But Herberman's warning traveled at seemingly the speed of light, because his memo drew swift reaction.
The response ranged from alarm to deep skepticism. The warning hit the news, and fears and questions flew. Every cell-phone user wondering about the safety of cell phones should know that the latest conclusive evidence is that the evidence is inconclusive. Sometimes, the best scientific answer to a question is, "We don't know yet." That's the best answer here.
Herberman certainly prompted phone calls among families and associates with his warning, although one must assume many of them were conducted on landlines. But if people are looking for the real skinny on cell phones and cancer, there simply is not enough evidence to make that call. If it helps, the largest single published study to date, which involved 420,000 Danish people and was published in the Journal of the National Cancer Institute in 2006, found no increased risk of cancer among those who used cell phones.
Herberman believes in early information in a still unpublished study, and he cites the lack of speed in getting such information out as the basis for his warning to the faculty and staff at the institute. Herberman's opinion should be respected. He seems quite serious in his concern. But there is no large, substantiated study showing a direct link between cell-phone use and cancer. Such evidence may emerge one day, but it hasn't happened yet. The best advice is to be practical. People should use their own common sense. If they believe the warning in Pittsburgh has merit, they should do what they have to do to reduce cell-phone use. If people see no basis in the warning, they will react by doing little to change.
There are, however, broad principles to remember when assessing such issues. For example, be skeptical of any study that might be funded by a cell-phone company. A conflict of interest is always possible when researchers believe their financier wants a particular outcome.
As with many health issues, it might be prudent to pay even more attention to science as it pertains to children. Kids' development can be quite different from effects on adults in a wide range of medical issues. The Pittsburgh warning is naturally causing increased concern among parents whose children use cell phones. But again, there is not enough information to make a case, either way, on what to believe. It is always good to urge government regulators to get the facts and be aggressive in protecting consumers. The public deserves reliable regulation.
The cell-phone controversy is reminiscent of a claim in the early days of color television that radiation from the color TVs was dangerous. Some people may still have that concern. It is also a reminder that, for a long time, cigarettes were not considered dangerous. Tobacco companies even advertised about brands' soothing effects. The world now knows the truth about tobacco.
Herberman's warning is certainly worth attention, but the bottom line on cell phones and cancer is that not enough is known to make the determination that a link exists. But it's certainly right to say scientists need to get a definitive answer for everyone, whatever that answer might be.
6 August, 2008
Religion and health
Does religious diversity go with poorer health? It says below that it does. But surely the USA has huge religious diversity and also high health standards? But I guess that most American denominations could all be lumped together as "Protestant" or some such. A Baptist, for instance, would not normally feel uncomfortable in a Methodist church (though he might feel uncomfortable in some other Baptist churches!)
Some people, notably Richard Dawkins, an evolutionary biologist at Oxford University, regard religion as a disease. It spreads, they suggest, like a virus, except that the "viruses" are similar to those infecting computers-bits of cultural software that take over the hardware of the brain and make it do irrational things.
Corey Fincher, of the University of New Mexico, has a different hypothesis for the origin of religious diversity. He thinks not that religions are like disease but that they are responses to disease-or, rather, to the threat of disease. If he is right, then people who believe that their religion protects them from harm may be correct, although the protection is of a different sort from the supernatural one they perceive.
Mr Fincher is not arguing that disease-protection is religion's main function. Biologists have different hypotheses for that. Not all follow Dr Dawkins in thinking it pathological. Some see it either as a way of promoting group solidarity in a hostile world, or as an accidental consequence of the predisposition to such solidarity. This solidarity-promotion is one of Mr Fincher's starting points. The other is that bacteria, viruses and other parasites are powerful drivers of evolution. Many biologists think that sex, for example, is a response to parasitism. The continual mixing of genes that it promotes means that at least some offspring of any pair of parents are likely to be immune to a given disease.
Mr Fincher and his colleague Randy Thornhill wondered if disease might be driving important aspects of human social behaviour, too. Their hypothesis is that in places where disease is rampant, it behoves groups not to mix with one another more than is strictly necessary, in order to reduce the risk of contagion. They therefore predict that patterns of behaviour which promote group exclusivity will be stronger in disease-ridden areas. Since religious differences are certainly in that category, they specifically predict that the number of different religions in a place will vary with the disease load. Which is, as they report in the Proceedings of the Royal Society, the case.
Proving the point involved collating a lot of previous research. Even defining what constitutes a religion is fraught with difficulty. But using accepted definitions of uniqueness, exclusivity, autonomy and superiority to other religions they calculated that the average number of religions per country is 31. The range, though, is enormous-from 3 to 643. C"te d'Ivoire, for example, has 76 while Norway has 13, and Brazil has 159 while Canada has 15. They then did the same thing for the number of parasitic diseases found in each country. The average here was 200, with a range from 178 to 248.
Obviously, some of the differences between countries are caused by differences in their areas and populations. But these can be accounted for statistically. When they have been, the correlation between the number of religions in a place and how disease-ridden it is looks impressive. There is less than one chance in 10,000 that it has come about accidentally.
The two researchers also looked at anthropological data on how much people in "traditional" (ie, non-urban) societies move around in different parts of the world. They found that in more religiously diverse (and more disease-ridden) places people move shorter distances than in healthier, religiously monotonous societies. The implication is that religious diversity causes people to keep themselves to themselves, and thus makes it harder for them to catch germs from infidels.
Of course, correlation is not causation. But religion is not the only cultural phenomenon that stops groups of people from mixing. Language has the same effect, and in another, as yet unpublished study Mr Fincher and Dr Thornhill found a similar relationship there too. Moreover, their search of the literature turned up work which suggests that xenophobia is linked psychologically with fear of disease (the dirty foreigner.). Perhaps, then, the underlying reason why there is so much hostility between ethnic groups is nothing to do with the groups themselves, but instead with the diseases they may bring.
Antibiotic HINDERS treatment of AIDS
A drug used to fight tuberculosis also hampers the effectiveness of an HIV treatment widely used in Africa, the world's worst AIDS-hit region, a study published today says. The antibiotic rifampicin reduces concentrations in the blood of nevirapine, a low-cost agent that is part of the frontline therapy against HIV in poor countries, especially Africa.
The study was presented ahead of the start of the 17th International AIDS Conference, which runs in Mexico City until Friday. The evidence comes from a study, unfolding in South Africa between 2001 and 2006, among 2,035 individuals who began their treatment with efavirenz, 1,074 of whom had TB, and 1,935 others who initiated with nevaripine, of whom 209 also had TB. In the nevaripine group, 16.3 per cent patients with TB were nearly twice as likely to have elevated levels of HIV in their blood at a six-month follow-up check compared to 8.3 per cent among those without TB. They were also twice as likely to develop treatment failure faster than patients who did not have TB. However, a large majority - 80 per cent - of TB patients using nevirapine also succeeded in suppressing the virus at an 18-month check-up.
The findings are of high importance for sub-Saharan Africa, which is home to two-thirds of the 33 million people infected by the human immunodeficiency virus (HIV). Around the world, an estimated one-third of the persons living with HIV are co-infected with TB. For reasons that are poorly understood, co-infection can cause a lightning-fast decline in health, especially if the TB strain is resistant to frontline antibiotics. The death rate among cases of co-infection is five times higher than for tuberculosis alone.
The JAMA study, led by Andrew Boulle of the University of Cape Town, South Africa, said it was unclear why rifampicin had such an impact on nevaripine. One possible reason could be a shared toxicity. Another could be a drug interaction, caused by rifampicin, when the patient started to receive early doses of the antiretroviral. Anti-HIV drugs suppress the virus but do not eradicate it completely. If the drugs are halted, the AIDS rebounds.
The study appears in next Wednesday's issue of the Journal of the American Medical Association (JAMA).
5 August, 2008
Brain study shows differences between homosexuals, straights
Brain differences are now well established and are becoming more so. The only question is whether the differences are genetic. There are arguments either way. The fact that heritability seems to be poor and no gene has been so far located argues against a genetic explanation. A developmental accident in utero seems more likely. My late sister was queer but there is no other known instance of it in the family -- JR
Is there such a thing as a "gay brain"? And, if so, are some people born with brains that make them more likely to be homosexual? Or do the brains of gay people develop differently in response to experiences? Those are some of the thorny questions that have been raised by a provocative new study that found striking differences between the brains of homosexuals and heterosexuals in both men and women.
Some scientists say the new findings are part of an increasingly convincing body of evidence that suggests sexual orientation results from fundamental developmental differences that are probably caused by hormonal exposures in the womb. "This research is pointing to basic differences in the brain between homosexual and heterosexual people that are likely there right from the beginning," said Sandra F. Witelson, a professor of psychiatry and behavioral neurosciences at McMaster University in Ontario. "These could be reflecting some genetic or hormonal factors that predetermine your sexual orientation."
Others, however, argue that such research is far from conclusive. "I remain skeptical," said William Byne, a professor of psychiatry at Mount Sinai School of Medicine in New York. "There's been a history of jumping to conclusions and overinterpreting findings in this field."
Several earlier studies have found what appear to be differences between the brains of gay and straight people. In 1991, brain scientist Simon LeVay reported that the hypothalamus, which is involved in sexual behavior, tended to be smaller in gay men [Size matters!]. Other researchers subsequently showed that the brains of gay and straight people appeared likely to respond differently to sexual images. The researchers who conducted the new study previously reported that the brains of gay and straight men seemed to react differently to suspected pheromones -- odors thought to be involved in sexual arousal.
But such research is fraught with uncertainty, and it could not rule out that the findings were the result of changes that occurred in response to experiences and behaviors, rather than being inborn. "The next question was 'If there is a difference, could there be differences in parts of the brain that have nothing to do with sexual behaviors?' " said Ivanka Savic of the Karolinska Institute in Stockholm, who led the new research published online last week by the Proceedings of the National Academy of Sciences.
So Savic and her colleague Per Lindstrom first used magnetic resonance imaging, or MRI, to compare the symmetry of the brains of 25 straight men and 25 straight women with those of 20 gay men and 20 gay women. Gay men tended to have brains that were more like those of straight women than of straight men -- the right and left sides were about the same size, the researchers found. Gay women's brains tended to be more like those of straight men than of straight women -- the right side tended to be slightly larger than the left.
Next, the researchers used positron emission tomography (PET) scans to examine how a part of the brain involved in processing emotions -- the amygdala -- was connected to other brain regions. Again they found that gay men tended to be more like straight women, with a stronger link between the amygdala and regions involved in emotions. Gay women tended to be more like straight men, with stronger connections to motor functions.
Savic and Lindstrom stressed that their findings need to be confirmed by additional research and that it remains unclear how the differences might affect behavior. While other researchers agreed, some said the findings about the amygdala could help explain why gay men tend to respond to emotional situations more like women and gay women more like men, and could even play a role in their sexual orientation. "This ancient structure is involved in 'orienting' our attention to biologically important stimuli in our environment (such as attractive partners . . .)," Qazi Rahman, who studies sexual orientation at Queen Mary, University of London, wrote in an e-mail.
Others said that that interpretation was highly speculative, but at the very least the findings support the idea that there tend to be fundamental differences in brain structure, supporting the idea that sexual orientation is inborn. "This suggests that there's something going on during development that influences sexuality and the brain," LeVay said. "It points more persuasively to some early biological difference." LeVay and other researchers said the findings fit with studies that found gay people tended to have different ratios in the lengths of their fingers and in the frequency of imperceptible clicking sounds in the ear.
"There's this cluster of interrelated findings," said Richard A. Lippa, a professor of psychology at California State University at Fullerton, who has found evidence that in gay men, the hair on the back of the head is more likely to curl counterclockwise than in straight men. "These are all biological markers that something must have gone on early in development."
These findings also fit with studies showing gay men tend to choose professions that typically attract women, such as teaching and social work, and have verbal and other cognitive skills that tend to be more like women's, he said. "You get a sort of global shift in gender traits in gay people and straight people that affects not only their sexual orientation but other things as well," LeVay said.
Many researchers suspect that changes may be the result of the levels of hormones, such as testosterone, that fetuses are exposed to in the womb. "We see the same asymmetries in the brains of rats and mice, and in rats and mice testosterone seems to be controlling it prenatally," said Marc Breedlove, a neuroscientist at Michigan State University.
But researchers say many questions remain about all this research. And there are as many differences within groups individuals of the same sexual orientation as between those of different orientation. Moreover, the new work involved adults, meaning there is no way to know with certainty when the structures and connections formed and why. "It takes a snapshot of a group of people at a particular age," said Anne Fausto-Sterling, a professor of biology and gender studies at Brown University. "Even if there are reliable brain differences, it doesn't tell you anything about how those brain differences came into being."
California nonsense comes to Australia
Push to ban 'dangerous' trans fats
The South Australian Government will push for a national ban or tougher controls on the use of trans fats in foods. The Government will use the next meeting of national food and health ministers in October to push for tougher regulations controlling the use of trans fats which have been linked to heart disease, strokes and diabetes.
Most trans fats consumed today are created by the hydrogenation of plant oils, a process that adds hydrogen atoms to unsaturated fats to render them more saturated, making them attractive for baking and extending their shelf life. "These really dangerous fats are in everyday foods that people eat and particularly in junk and processed foods," said SA Premier Mike Rann. "Trans fats offer no nutritional value whatsoever and indeed are linked to serious health issues."
Mr Rann said the state government also wanted restaurants and food manufacturers to label their menus and products to allow consumers to know exactly what they were eating. He said the Government was about to start working with other states on a national survey to determine how much trans fats were in common foods. "We believe the time to act on trans fats is now," Mr Rann said. "We need to regulate these fats and protect Australians."
4 August, 2008
Humans are tougher than mice
Animal models continue to influence our understanding of immunity to infection, but how accurately do they predict how our own immune systems respond to different pathogens? Von Bernuth et al. (p. 691) continue a series of studies in which they use rare human immune deficiencies to help unpick the roles played by distinct innate immune pathways. The study focuses on MyD88, a signaling adaptor that is crucial in mice for protection against a wide range of pathogens by connecting key Toll-like receptor (TLR) and interleukin-1 (IL-1) pathways to the activation of immune response genes. In contrast to findings in mice, deficiency of the same protein in the human patients caused susceptibility to only a handful of pyogenic bacteria, despite leaving the subjects with broad deficits in their TLR and IL-1 responses.
Pyogenic Bacterial Infections in Humans with MyD88 Deficiency
By Horst von Bernuth et al.
MyD88 is a key downstream adapter for most Toll-like receptors (TLRs) and interleukin-1 receptors (IL-1Rs). MyD88 deficiency in mice leads to susceptibility to a broad range of pathogens in experimental settings of infection. We describe a distinct situation in a natural setting of human infection. Nine children with autosomal recessive MyD88 deficiency suffered from life-threatening, often recurrent pyogenic bacterial infections, including invasive pneumococcal disease. However, these patients were otherwise healthy, with normal resistance to other microbes. Their clinical status improved with age, but not due to any cellular leakiness in MyD88 deficiency. The MyD88-dependent TLRs and IL-1Rs are therefore essential for protective immunity to a small number of pyogenic bacteria, but redundant for host defense to most natural infections.
Science 1 August 2008: Vol. 321. no. 5889, pp. 691 - 696
Hormone hope in schizophrenia fight
The "female" hormone estrogen promises new hope to both men and women who suffer from the debilitating symptoms of schizophrenia. Sydney researchers are about to begin a trial of the hormone on people with the mental illness, following a discovery of a genetic glitch that impedes estrogen from doing its job in the brain. The finding comes from an international team led by neurobiologist Cyndi Shannon Weickert, head of a project initiated by the University of NSW, the Prince of Wales Medical Research Institute and the Schizophrenia Research Institute.
Professor Shannon Weickert's team discovered that mutations in the estrogen receptor alpha (ESR1) gene disrupt a cascade of biochemical events in the brains of people with schizophrenia. The result is that estrogen is less able to moderate emotions and thinking. The report -- published recently in the journal Human Molecular Genetics -- "confirms" that estrogen is an important target for drug therapy, said Melbourne University psychiatrist Michael Berk, also with Barwon Health, The Geelong Clinic and the Orygen Research Centre.
Just over 1 per cent of people worldwide suffer the hallucinations, delusions and disordered thinking of the developmental brain disorder. They also may experience "negative" symptoms such as depression, loss of motivation and social avoidance. While anti-psychotic drugs such as chlorpromazine manage "positive" symptoms such as hallucination, they do little for the negative ones.
Monash University psychiatrist Jayashri Kulkarni who is currently heading a three-centre trial of the hormone, involving Professor Berk, said: "The evidence is very clear that estrogen protects the brain from symptoms of psychosis."
3 August, 2008
Dangerous salt phobia in Britain
Moves to cut salt levels in bacon and ham risk increasing potentially fatal cases of the paralysing food bug botulism, the Food Standards Agency has been warned. Ham processors are particularly concerned at moves to reduce salt content to 2.13g per 100g by 2010 and to 1.75g by 2012. They said their concern was not because of a resistance to change, but was related to the health risks. Other food sectors are also unhappy about the revised salt reduction targets from the watchdog, which they insist are putting consumers off sandwiches and ready meals.
The issue threatens to create a rift between the food industry and the agency. But health campaigners are urging the FSA to stand firm and to resist what they say is scaremongering from an industry reluctant to change its manufacturing practices. Malcolm Kane, an independent food technology consultant who advises the campaign group Consensus Action of Salt in Health, suggested that the objections from industry were because companies feared the shelf-life of products may have to be reduced below the current average of ten-day "use by" dates: "I'm disappointed. It is just a feeble excuse for doing nothing about salt levels. They don't want to lower salt levels because they are nervous about consumer reaction and people not liking the taste with less salt."
The agency suggested last month that 14,000 premature deaths a year could be avoided if adults reduced salt intake to 6g a day. The current average is 8.6g a day, already down from 9.5g in 2001.
Claire Cheney, director-general of the Provision Trade Federation, which represents leading processed meat companies, has denounced the targets as unrealistic and a potential risk to human health. "If you have not got sufficient preservative in a product like ham you get pockets where the salt levels are too low to prevent the formation of the botulism toxin."
She told The Grocer magazine: "This will force us to reduce it [the shelf-life] further and with that come serious food safety concerns, not least the risk of botulism." She said that salt was in the product for technological reasons not for taste. Her view is supported by the British Meat Processors Association. Elizabeth Andoh-Kesson, its technical manager, said: "We are very worried about the stricter targets and believe that reducing salt further has implications for food safety and shelf life of products," she said.
Other trade associations are also objecting to further salt cuts. Jim Winship, the chairman of the British Sandwich Association, denounced the targets as "absolutely staggering". He said: "We are already getting complaints from retailers that consumers don't like the blandness of many sandwiches to meet existing salt targets. Sandwich makers don't add salt to sandwiches at all but it is in products such as cheese, bacon and ham. We'll soon be at a point where people stop buying sandwiches and make them at home where they add as much salt as they want. This would affect an important industry. We sell 2.8 billion packs of sandwiches a year with a market value of 5.25 billion pounds."
Ready-meal manufacturers such as Northern Foods and Kerry Foods, which are represented by the Chilled Food Association, are also anxious that further salt reductions will affect their œ9 billion a year market. Kaarin Goodburn, the secretary-general, said: "We are already reformulating many recipes but we have got reports that consumers don't like the taste especially in some healthy ranges of meals, such as lasagne, where there has been a decline in sales. What's the incentive to reformulate if it results in falling sales? People are already putting in lots more herbs instead of salt but many people don't like the taste. " Peter Sherratt, the general secretary of the Salt Association, said that feed-back from its members suggested that the agency targets had gone too far."
Cut out those peas if you really want a bundle of joy
'Tis the season to go on a diet. The bikini diet. The beach body diet. Or, the latest diet on the scene: The Fertility Diet, which claims that cutting out certain foods can help maximise your chance of having a baby "at any age".
Thus it is a diet that, if successful, will actually make you gain weight, but no matter - 21st-century women with careers and chaotic love lives adore this kind of thing, for it allows us to stick our fingers in our ears and say "la, la, la, I CAN'T HEAR YOU", to our biological clocks, safe in the belief that when we are in our forties - or even fifties, according to this book - a bouncing bundle of joy will be ours if we cut out peas.
Seriously. According to the author, Sarah Dobbyn, peas are the enemy of women trying to conceive. As is rhubarb, but how often do you eat that? Eggs and fruit juices should also be avoided. Meat, sugar, dairy, alcohol... anything that might remotely pass for fun or get you in the mood is a no-no.
Ms Dobbyn, who also explores the effect of the moon on fertility, has no medical qualifications. She is a nutritionist who used to be a barrister, so we must credit her with some intelligence, but her assertion that your diet might lead to you getting pregnant in your fifties is a tad moronic considering only a handful of people around the world have babies at this age, usually thanks to IVF rather than the waxing and waning of the moon. The fact remains that fertility still declines rapidly once we hit 35.
To claim otherwise sends out a dangerous message to young women, who already believe that IVF will sort things out. Witness Angelina Jolie, whose new-born twins were apparently made in a test-tube because she couldn't be bothered to try to conceive naturally - and this woman goes out with Brad Pitt.
Dobbyn says her book will allow the Bridget Jones generation to hit the snooze button on their biological clocks, so they can "find the right man without that element of panic", which is very kind of her, if a bit patronising.
Dobbyn herself is 43 - young in the grand scheme of things, but cutting it fine when it comes to starting a family, which she said she shortly hoped to do in an interview at the weekend. I wish her luck, but can't help thinking that life would be easier if we admitted that Mother Nature, cruel mistress that she is, has precious little time for members of the sisterhood over 35.
It could be worse. We could live in Russia, where a woman has lost her case for sexual harassment after a judge ruled that employers were obliged to try it on with staff to ensure the survival of the human race. And no, I am not making this up.
Apparently, it's all part of the job description over there, where a recent survey found that 80 per cent of women believed that the only way to get a rise is to carry out sexual favours. Western women may want it all - work and babies - but as this case proves, perhaps we should be careful what we wish for.
2 August, 2008
The state-sanctioned bullying of fat kids
Why is Britain opening so many `fat camps'? The evidence suggests they don't work, and only make overweight children feel isolated and ashamed
Last year's erroneously titled Foresight report on obesity, published by the UK government, recommended `fat camps' for overweight British teenagers, because apparently radical strategies are necessary to avert a public health catastrophe. This draconian policy found its way into the government's evidence-free obesity strategy, Healthy Weight, Healthy Lives, which prescribes anti-obesity interventions at the local level.
Consequently, Rotherham Primary Care Trust, as part of the new Rotherham Obesity Strategy, has unveiled a three-year plan targeting families with overweight children. The Trust identified Rotherham's fattest children and this summer banished 38 of them to a fat camp, the Carnegie Residential Weight Loss Camp, in Leeds.
This is not the first time that fat British children have been sent away because they are aesthetically unpleasing to their parents, peers and the public health establishment. The summer of 1999 saw Britain's first residential fat camp (based on the American model) open its doors to 40 overweight children. The Too Fat to Toddle camp, the first British fat camp for under-fives, opened for business late last year.
This week, officialdom's war against fat children was stepped up a mark. The government revealed that, starting in the next school term, parents will be sent `fat reports' on their children. As part of the anti-obesity crusade, schools will weigh children at the age of four to five and again at 10 to 11 and send details about their Body Mass Index to parents, with advice on whether their child's weight is unhealthy. And Sunday's Observer reported that Britain's first live-in fat camp - a `boarding school exclusively for overweight and obese teenagers' - will open soon in the Lake District.
It is deeply frustrating that British policymakers did not heed the lessons of the American experience, where fat camps have existed for 45 years, before unleashing yet another futile childhood obesity intervention.
The first fat camp for children, New York State's Camp Napanoch, opened in 1963. Three years later, it was out of business. During the next 30 years, a large number of fat camps appeared across America. Eventually, the fat camp business turned sour and most camps went bust. By the mid-1990s, there were fewer than 20 fat camps in operation. Today, there are only a dozen left.
Why is business so bad in America, the world leader in fat children and obsessive parenting? Because the dirty little secret of fat camps is that they do not work. It is true that often a child will go to a fat camp and return home a stone or two lighter. At the UK's original fat camp in Leeds, obese teenagers typically lose 12lb over a one-month residential stay.
Chances are, however, that they will regain the weight in a few months. The Los Angeles Times reported that only one in 10 American campers actually keep the weight off. A New York Times investigation found that the majority of campers attending these programmes are repeat customers.
Individual camp's self-reporting success stories are littered with methodological problems, as most fat camps neither track nor report post-camp outcomes. Most do not remain in contact with their customers and camp `graduates' cannot be trusted to honestly respond to questionnaires that attempt to keep tabs on their weight history.
Most fat campers regain substantial amounts of weight within the first year. In a warning to parents, Dr Oded Bar-Or, director of McMaster University's Children's Exercise and Nutrition Center, said: `If you think the camp is going to solve the problem - the child will at long last lose weight and keep it that way - you can forget it.'
Therefore, it is unsurprising, yet deeply revealing, that the Rotherham Obesity Strategy provides information neither on the anticipated effectiveness of its own fat camps nor on the effectiveness of similar camps. To be fair, it cannot do so because there is no empirical evidence, as the Foresight report acknowledged, that government intervention in this area produces the desired outcome.
Most tellingly, perhaps, last autumn a qualitative study of the management of childhood obesity was published in the journal, BMC Family Practice. In this study, a representative group of primary care doctors in the 39 general practices that contract with Rotherham Primary Care Trust concluded that the evidence base for these programmes remains poor.
Earlier, the prestigious Cochrane systematic reviews of interventions for childhood obesity, which included 18 studies of various different treatments, found none of them to be effective....
Fat camps isolate children with a weight problem and add to the distress of an obese child. Professor Nick Finer of Luton and Dunstable Hospital's Obesity Research Centre, says: `You have to consider the psychological effects of sending your child away to such a place. Society already discriminates against fat people and I'm concerned that children might see being sent to these camps as a punishment for being fat.'
Fat children are expected to suffer, with stereotypical jolliness, the slings and arrows of a society dangerously obsessed with thinness. Probably, school playgrounds will always witness the bullying of fat children. But, as adults, we can and should eliminate fat-based bullying from government policy.
LA blocks new fast-food outlets from poor areas
Arrogant and ill-informed paternalism redeemed only by its total ineffectiveness
City officials are putting South Los Angeles on a diet. The City Council voted unanimously Tuesday to place a moratorium on new fast food restaurants in an impoverished swath of the city with a proliferation of such eateries and above average rates of obesity. The yearlong moratorium is intended to give the city time to attract restaurants that serve healthier food. The action, which the mayor must still sign into law, is believed to be the first of its kind by a major city to protect public health."Our communities have an extreme shortage of quality foods," City Councilman Bernard Parks said.
Representatives of fast-food chains said they support the goal of better diets but believe they are being unfairly targeted. They say they already offer healthier food items on their menus. "It's not where you eat, it's what you eat," said Andrew Pudzer, president and chief executive of CKE Restaurants, parent company of Carl's Jr. "We were willing to work with the city on that, but they obviously weren't interested."
The California Restaurant Association and its members will consider a legal challenge to the ordinance, spokesman Andrew Casana said.
Thirty percent of adults in South Los Angeles area are obese, compared to 19.1 percent for the metropolitan area and 14.1 percent for the affluent Westside, according to the Los Angeles County Department of Public Health.
Research has shown that people will change eating habits when different foods are offered, but cost is a key factor in poor communities, said Kelly D. Brownell, director of Yale University's Rudd Center for Food Policy and Obesity. "Cheap, unhealthy food and lack of access to healthy food is a recipe for obesity," Brownell said. "Diets improve when healthy food establishments enter these neighborhoods."
A report by the Community Health Councils found 73 percent of South Los Angeles restaurants were fast food, compared to 42 percent in West Los Angeles.
South Los Angeles resident Curtis English acknowledged that fast food is loaded with calories and cholesterol. But since he's unemployed and does not have a car, it serves as a cheap, convenient staple for him. On Monday, he ate breakfast and lunch _ a sausage burrito and double cheeseburger, respectively _ at a McDonald's a few blocks from home for just $2.39. "I don't think there's too many fast food places," he said. "People like it."
Others welcomed an opportunity to get different kinds of food into their neighborhood. "They should open more healthy places," Dorothy Meighan said outside a Kentucky Fried Chicken outlet. "There's too much fried stuff." Councilwoman Jan Perry said that view repeatedly surfaced at the five community meetings she held during the past two years. Residents are tired of fast food, and many don't have cars to drive to places with other choices, she said.
Los Angeles' ban comes at a time when governments of all levels are increasingly viewing menus as a matter of public health. On Friday, California became the first state in the nation to bar trans fats, which lower levels of good cholesterol and increase bad cholesterol.
The moratorium, which can be extended up to a year, only affects standalone restaurants, not eateries located in malls or strip shopping centers. It defines fast-food restaurants as those that do not offer table service and provide a limited menu of pre-prepared or quickly heated food in disposable wrapping.
The definition exempts "fast-food casual" restaurants such as El Pollo Loco, Subway and Pastagina, which do not have drive-through windows or heat lamps and prepare fresh food to order. The ordinance also makes it harder for existing fast-food restaurants to expand or remodel.
Rebeca Torres, a South Los Angeles mother of four, said she would welcome more dining choices, even if she had to pay a little more. "They should have better things for children," she said. "This fast food really fattens them up."
1 August, 2008
Study shows exposure to some types of air pollution raises blood pressure in some rats in some circumstances
My heading above is accurate. The original heading was: "Study shows exposure to bad air raises blood pressure"
The air people breathe while walking in the park, working in the garden or shopping downtown may be unhealthy enough to seriously spike their blood pressure, a new study suggests.
Cardiovascular researchers at The Ohio State University Medical Center are the first to report a direct link between air pollution and its impact on high blood pressure, or hypertension. If the results from these animal studies hold up, this could be important for human health. "We now have even more compelling evidence of the strong relationship between air pollution and cardiovascular disease," said Sanjay Rajagopalan, section director of vascular medicine at Ohio State's Medical Center and co-author of the study. This builds upon previous research from Rajagopalan's team published in the journals JAMA, Circulation and Inhalation Toxology.
Researchers exposed rats to levels of airborne pollutants that humans breathe everyday, noting the levels were still considerably below levels found in developing countries such as China and India, and in some parts of the U.S.
Researchers found that short-term exposure to air pollution, over a 10-week period, elevates blood pressure in those already predisposed to the condition. The results appear online and are scheduled for publication in an upcoming issue of Arteriosclerosis, Thrombosis, and Vascular Biology, a journal published by the American Heart Association. "Recent observational studies in humans suggest that within hours to days following exposure, blood pressure increases," Rajagopalan says.
In a highly-controlled experiment, hypertensive rats were placed in chambers and exposed to either particulate matter or filtered air for six hours a day, five days a week, over a period of 10 weeks. At week nine, researchers infused angiotensin II, another pollutant, into mini-pumps within the chambers and monitored responses in blood pressure over one week.
The air pollution level inside the chamber containing particulate matter was comparable to levels a commuter may be exposed to in urban areas with heavy traffic such as downtown Manhattan. "Pre-exposure to air pollution markedly increased blood pressure responses following infusion of angiotensin II," added Rajagopalan.
According to the U.S. Environmental Protection Agency (EPA), the four most common pollutants emitted into the air are particulate matter, ozone, nitrogen dioxide and sulfur dioxide. Air pollution is commonly the result of industrial emissions, coal burning, power plants and automobile exhaust. "This study provides guidance for the EPA to change pre-existing stringent standards in the effort to reduce air pollution," says Rajagopalan. "Our study also confirmed a need for a broader based approach, from the entire world, to influence policy development."
Qinghua Sun, first author of the study, will analyze vascular function in humans before and after the upcoming summer Olympics in Beijing, China. With stringent laws to ensure good quality during the games, it is anticipated that the air quality will improve significantly in and around Beijing. "We expect to find a tangible impact on vascular function and blood pressure because ultimately the only thing that will have changed is levels of air pollution," says Sun.
DNA discovery in schizophrenia
Those pesky genes again!
THREE studies of more than 60,000 people have identified a range of genetic abnormalities linked to schizophrenia, including missing sections of DNA. The discoveries represented a milestone in determining the genetic basis of the complex mental disorder which affects one in 100 Australians, scientists said.
Bryan Mowry, executive director of the Queensland Centre for Mental Health Research, and a co-author of one of the studies, said the findings could help determine the biological causes of the debilitating disease so new treatments could be developed. They could also eventually lead to tests for earlier diagnosis of the condition, which doctors can only identify now from symptoms including hallucinations and delusions. "Hopefully, that will be one of the outcomes," he said.
The study, in which Professor Mowry took part, included people with bipolar disorder, and the results suggested this condition had genetic risk factors in common with schizophrenia, he said. The three studies, published in the journals Nature and Nature Genetics, succeeded where smaller studies had failed because they looked at large numbers of people and searched right across the 3 billion letters of the human DNA code.
Two types of abnormalities were found: in single letters in the code, and in large chunks of DNA involving more than 100,000 letters, which were either missing or repeated in some people with the disease.
A team led by scientists at an Icelandic company, deCODE genetics, identified three genetic deletions which can occur spontaneously when eggs and sperm are created. These gaps in the DNA code were rare but increased the risk of schizophrenia between three- and 15-times.
The International Schizophrenia Consortium, involving researchers from 11 institutes in Europe and the US, also independently discovered two of these three deletions. They also found that people with schizophrenia were more likely to have other gaps or duplicated sections elsewhere in their genetic code that could disrupt the action of other genes.
The third international team, which included Queensland researchers, identified three single letter mutations linked to increased risk. The researchers cautioned it would be premature to develop genetic tests for a predisposition to schizophrenia based on the findings because they did not account for all cases of the disease.