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SYSTOLIC BLOOD PRESSURE THE CRUCIAL FACTOR FOR OVER 50s Measuring and diagnosis of high blood pressure (hypertension) should be done using systolic blood pressure only in patients aged over 50 years, rather than using both systolic and diastolic as is current practice. The proposal is put forward by three hypertension experts is published early Online in The Lancet. Bryan Williams, University of Leicester and Leicester Royal Infirmary, UK, Lars H. Lindholm, Umeå University Hospital, Sweden, and Peter Sever, International Centre for Circulatory Health, Imperial College London, UK, say that, because of aging populations, systolic hypertension (SH) is becoming much more common and important due to its high prevalence in patients over 50, compared with diastolic hypertension (DH). SBP rises with age; but DBP only rises until age 50 years and falls thereafter, at a time when risk of cardiovascular disease begins to rise. Thus there is an increased prevalence of SH over age 50 years and an almost total disappearance of DH. The authors say: “Since more than 75% of people with hypertension are aged over 50 years, the burden of disease in mainly due to systolic pressure. The use of diastolic pressure for diagnosis and risk analysis in our ageing populations has thus become illogical.” In order to simplify treatment strategies for physicians and policy makers, as well as to better focus the minds of drug innovators on the correct targets, the authors propose that, in patients over 50, only SBP needs to be measured, for four reasons. Firstly, SBP is more easily and accurately measured than DBP and is a better predictor of risk. Second, communication with patients would be much easier with just one number, ie, their SBP, since two different numbers leave many of them confused about which is of greater significance. Third, doctors themselves have received many conflicting messages about SBP and DBP, and many still use DBP to guide treatment decisions. This proposal would simplify things for them. And lastly, focussing a public-health campaign on a single number for people aged over 50 years has the potential to dramatically improve treatment outcomes for those with SH, and reduce the associated disease and death rates. http://www.thelancet.com CONCERN FOR CHILD HEALTH FROM PLASTICS CHEMICAL A chemical used in the production of polycarbonate plastics, bisphenol A (BPA), is raising concern over its effects in fetuses and children, according to a draft report from the NIH. The report, from the National Toxicology Program, concludes that BPA presents "some concern" that exposure of fetuses and children "can cause changes in behavior and the brain, prostate gland, mammary gland, and the age at which females attain puberty." The report cites "negligible concern" that BPA exposure leads to birth defects. Polycarbonate plastics are used in, among other things, bottles for water and infant formula or breast milk. The draft report says that infants and children have the highest intakes of BPA in the population. National Toxicology Program report (Free PDF) http://click.jwatch.org/cts/click?q=227%3B66921617%3BXbrIfq6e8%2BoKrMw68XXQ7sPj%2F%2FFAogr9zGBw09yk56M GUM DISEASE LINKED TO CANNABIS SMOKING Cannabis smoking may be a risk factor for periodontal disease, according to a prospective cohort study in JAMA. The study, conducted in New Zealand, followed about 900 adults from age 18 to 32. After controlling for tobacco use and other risk factors, the researchers found that by age 32, heavy cannabis users (41 or more times in the previous year) were three times more likely to have periodontal disease (at least one site with 5 mm or greater combined attachment loss) than those who'd never used cannabis. http://jama.ama-assn.org/cgi/content/full/299/5/525 NO LINK BETWEEN MMR AND AUTISM According to the findings of a study published early online in the Archive of Diseases of Childhood, “there is no evidence of a link between the MMR vaccine and autism”. The new data come 10 years after the original Lancet article which called into question the safety of the MMR vaccine. Researchers from Guys Hospital, the Health Protection Agency (HPA) and Manchester University, conducted a community based case-control study to establish if there was a link between diagnosis of a child's condition, presence of measles virus and antibody levels in UK children. http://www.gnn.gov.uk/environment/fullDetail.asp?ReleaseID=350235&NewsAreaID=2&NavigatedFromDepartment=False FRUCTOSE LINKED WITH INCREASED GOUT RISK High consumption of sugar-sweetened soft drinks and fructose may increase the risk for gout in men, BMJ reports. More than 46,000 male health professionals aged 40 to 75 completed food-frequency questionnaires at baseline and every 4 years thereafter. During 12 years' follow-up, 1.6% developed gout. After multivariable adjustment, gout risk rose significantly with increasing consumption of sugar-sweetened soft drinks. Compared with men who consumed less than one sugary soft drink a month, those consuming five to six drinks a week had a 29% increased risk; one a day, a 45% increase; and two or more daily, an 85% increase. Risk also rose with increasing consumption of other high-fructose products, such as fruit juice, apples, and oranges. As a potential mechanism underlying the association between fructose and gout risk, the authors note that fructose increases ATP degradation to AMP, thereby increasing production of uric acid. http://www.bmj.com/cgi/content/full/bmj.39449.819271.BEv1 CAFFEINE MAY IMPAIR GLUCOSE CONTROL IN TYPE 2 DIABETES Patients may ask about a widely reported study in Diabetes Care, which found that consuming 500 mg of caffeine daily (about 4 cups of coffee) might impair glucose control in those with type 2 diabetes. The study included 10 coffee drinkers whose diabetes was controlled with diet, exercise, and oral medications. On day 1, participants took 250 mg of caffeine or placebo pills at both breakfast and lunch, and on day 2, they took the opposite treatment. They consumed no other caffeine during the study. The average daytime glucose level was significantly higher on the day patients took caffeine (144 mg/dL) than on the placebo day (133 mg/dL). Average postprandial glucose levels were also elevated with caffeine. The authors say the study "raises concerns about the potential hazards of caffeinated beverages for patients with type 2 diabetes." They conclude that frequent elevations in glucose from daily caffeine consumption may potentially raise risk for diabetes complications. http://care.diabetesjournals.org/cgi/content/extract/31/2/221 CANNABINOIDS FOR CHRONIC PAIN Cannabinoids is effective for chronic pain but research is needed to decide which subgroups of people benefit most according to an editorial in the BMJ - 26th Jan 2008. The past decade has seen a resurgence in the interest in this subject and at least two subtypes of cannabinoid receptors have been identified. Many clinical studies have been published examining the effectiveness of tetrahydrocannabinol derivatives for acute pain, pain caused by chronic non-malignant disease, and pain from cancer. Evidence of the effectiveness of cannabinoids is strong for treating cancer, central pain, and spasticity related pain; the evidence is mixed for treating acute pain and weak for treating peripheral neuropathic pain. http://www.bmj.com GASTRIC BANDING BRINGS REMISSION IN TYPE 2 DIABETES Gastric banding far outperforms conventional therapy in achieving remission of type 2 diabetes, according to an industry-sponsored, preliminary study in JAMA. Australian researchers randomized 60 obese patients (BMIs between 30 and 40) with type 2 diabetes to laparoscopic adjustable gastric banding or "best practice" conventional therapy. When assessed 2 years later, 73% of the surgical group had achieved remission versus 13% of the conventional-therapy group. Likewise, weight loss averaged 20% of baseline with surgery and 1.4% with conventional therapy. Writers, citing the Australian surgical team's high level of experience, say "their excellent results may not be ... reproducible elsewhere." And they acknowledge that the "general applicability of these findings remains to be determined." Nonetheless, they observe that guidelines for diabetes care "do not mention surgery at all, even for severely obese patients." They urge professional societies and clinicians to "reconsider the role of surgery to treat diabetes." OBESITY A PRECURSOR TO DISEASE Excess weight during childhood increases the risk for coronary heart disease during adult years, portending serious public health consequences, according to two studies in the New England Journal of Medicine. The first study, based on annual height-and-weight measurements in some 275,000 Danish schoolchildren, followed their health after age 25. Researchers found that higher BMI scores predicted higher risks for coronary diseases -- both fatal and nonfatal -- in adulthood. For example, a 13-year-old boy overweight by 11 kg (25 pounds) had a 33% higher risk for coronary disease in adulthood. The second study, using a model based on U.S. health statistics, finds that with current rates of childhood obesity, the prevalence of coronary disease will increase between 5% and 16% by 2035. http://content.nejm.org/cgi/content/full/357/23/2329 FIT TO BE FAT Maintaining cardiorespiratory fitness may be at least as important as avoiding obesity in reducing mortality among the aged, researchers report in JAMA. A cohort of some 2600 adults aged 60 or older underwent a baseline health exam and exercise testing. After a mean follow-up of 12 years, the authors write, "both fitness and BMI were strong and independent predictors of all-cause mortality," regardless of other measures of adiposity, such as body-fat percentage. They also found that people who were fit and obese had a lower risk for all-cause death than did people who were unfit and normal weight or lean. They conclude: "It may be possible to reduce all-cause death rates among older adults, including those who are obese, by promoting regular physical activity, such as brisk walking for 30 minutes or more on most days of the week." http://jama.ama-assn.org/cgi/content/short/298/21/2507 NEW ADENOVIRUS VARIANT CAUSING SEVERE DISEASE The US Centre for Disease Control and Prevention (CDC) reports that a new adenovirus variant has caused at least 140 cases of severe respiratory illness in the United States, including 10 deaths. After the first case in an infant in New York, additional clusters were confirmed in Oregon, Washington, and Texas during March to June 2007. Nearly 40% of the patients were hospitalized, 17% in intensive care. The cases suggest "a new and virulent" variant of adenovirus serotype 14 (Ad14), concludes a report in the CDC Morbidity and Mortality Weekly Report (MMWR.) http://click.jwatch.org/cts/click?q=227%3B66812008%3Bfi2KGDb4cBTWeD977FirkYKWylDtrWxQ27aVOk7Fv7o%3D ORAL CONTRACEPTIVE AND CERVICAL CANCER LINK Use of oral contraceptives for five or more years doubles the risk for invasive cervical cancer, but the risk decreases progressively after stopping use, according to a LANCET study. Researchers examined data on oral contraceptive use from 24 studies comprising some 11,200 women with invasive cervical cancer and 35,500 controls. The risk for cancer increased with duration of use, was highest in current users, and declined with time since last use. Among those who had stopped using oral contraceptives for 10 years or more, the risk was similar to that of never users. To give a sense of the additional risk, the authors estimate that 10 years use starting at age 20 would raise the cumulative cancer incidence at age 50 from 3.8 to 4.5 per 1000 women. There is a potential confounding factor: Women using oral contraceptives are more likely to be exposed to HPV than are those using barrier methods or not having sexual intercourse. http://click.jwatch.org/cts/click?q=227%3B66806925%3BOKhoOfXjJCzGaN4AURmg5mZFWPntQ0OVw%2BQCmQKAaTU%3D PRE-ECLAMPSIA AND HEART DISEASE: A BIDIRECTIONAL LINK Pre-pregnancy cardiovascular risk factors are associated with increased preeclampsia risk, and in turn, preeclampsia may increase the risk for subsequent cardiovascular disease, according to two studies in BMJ. In one study, researchers measured cardiovascular risk factors and then assessed pregnancy outcomes about 4 years later; some 3500 women who gave birth to singletons were included. After multivariable adjustment, women with the highest prepregnancy blood pressures had about seven times the risk for preeclampsia, while those with the highest BMIs, waist circumferences, or LDL or total cholesterol levels had twice the risk. The second study, a meta-analysis involving nearly 200,000 women who'd had preeclampsia and 3.3 million who had not, found that the condition increased the risk for hypertension, ischemic heart disease, stroke, and venous thromboembolism 5 to 14 years later. According to authors, women who’ve had preeclampsia should undergo cardiovascular risk assessment 3 to 6 months after delivery, as well as early screening for traditional CVD markers. http://www.bmj.com/cgi/content/full/bmj.39366.416817.BEv1 WAYS TO PREVENT CANCER THROUGH DIET AND EXERCISE The World Cancer Research Fund and the American Institute for Cancer Research have released a comprehensive, 500-page report detailing ways for people to reduce their risk for cancer through diet and exercise. It is reviewed in the BMJ. The recommendations include: Achieve and maintain a BMI within the normal range. (The panel found convincing evidence linking body fat to six types of cancer.) Exercise 30 to 60 minutes a day. Eat no more than 18 oz. of red meat per week, with little processed meat. Limit alcoholic drinks to one a day for women and two a day for men. Consume less than 6 g of sodium daily. Do not use dietary supplements to prevent cancer. The panel also released special recommendations for nursing mothers and cancer survivors. http://click.jwatch.org/cts/click?q=227%3B66798701%3BKLLuleCV90NQH7SczOSCJrJF07auINQQC8PGuQltg3I%3D
HIGH CHOLESTEROL INCREASES STROKE SURVIVAL RATE A retrospective analysis from a long-running Danish study of strokes reports that there seems to be an inverse relationship between blood cholesterol levels and stroke severity - patients with high levels seem to have less severe strokes and lower stroke mortality. The Copenhagen Stroke Study is a ten-year follow-up of a cohort of patients admitted to a hospital stroke unit serving a population of about 240,000 people; about 88% of strokes in this population during the inclusion period (March 1992 to November 1993) were admitted to the unit. Patients were generally elderly (mean age 74.8) and their mean stroke score was 38.6. Variables that increased stroke severity included age, previous stroke, diabetes, and atrial fibrillation. Total cholesterol level was inversely associated with stroke severity, with each 1mmol/l increase approximating to an increase of 1.32 in the SSS score. Over the ten-year analysis, increasing blood cholesterol was associated with increased survival, with a hazard ratio of 0.89 (95% CI 0.82 to 0.97, P=0.01) for each 1mmol/l increase. The authors conclude that increased total cholesterol levels in people with stroke are associated with higher SSS scores and greater chance of survival. As the SSS score is correlated with infarct size, this suggests that strokes in hypercholesterolaemia are mainly small and thus due to small vessel obstruction. They comment that the association between cholesterol levels and stroke is not clear, with conflicting results from studies, and suggest that their work may clarify the issue. http://stroke.ahajournals.org/cgi/content/abstract/38/10/2646 A BAD MARRIAGE MAY INCREASE HEART DISEASE RISK People who have frequent negative interactions with the person to whom they feel closest may be at increased risk for heart disease, reports the Archives of Internal Medicine (October 8, 2007). Some 9000 British civil servants without histories of coronary disease completed questionnaires on their interactions with their closest personal relation (most often a spouse) during the previous year. The incidence of myocardial infarction or angina was evaluated during about 12 years of follow-up. In analyses controlling for demographic and biological confounders (e.g., age, sex, marital status, obesity, hypertension, diabetes, and cholesterol level), patients in the highest tertile of negative interactions were 34% more likely to experience coronary events than those in the lowest tertile. http://archinte.ama-assn.org/cgi/content/short/167/18/1951 NEW HPV VACCINE LAUNCHED Cervarix® (Human Papillomavirus Vaccine [Types16,18] Recombinant, adjuvanted adsorbed), from GlaxoSmithKline, was launched 2nd October 2007. It is said to protect against the two strains of the human papillomavirus (HPV) that cause the majority of cervical cancers – HPV16 and HPV18. Despite the central role this virus plays in the development of cervical cancer, a recent study shows that only 2.5% of British women know that it is responsible for a cancer that results in approximately 3,000 new cases and 1,000 deaths each year in the UK. The study, published in the British Journal of Cancer, found that in terms of “name recognition” – simply having heard of HPV – around three-quarters of women in the UK had never heard of the virus. Even amongst those who had heard of HPV, just a fraction knew it caused cervical cancer. A study published by the Health Protection Agency (HPA) found that by the age of 22, almost a third of women in England will have previously encountered HPV 16 – the strain of the virus most commonly associated with cervical cancer. In June the Government agreed in principle that girls aged around 12 to 13 should be vaccinated against HPV. The Joint Committee on Vaccination and Immunisation, the body of experts which advises the Government on vaccination issues, is expected to make formal recommendations to Health Ministers later in the year. A decision on whether other age groups should be able to benefit from a national vaccination programme against cervical cancer is still pending. The new GlaxoSmithKline (GSK) cervical cancer vaccine is indicated for girls and women for the prevention of high-grade precancerous lesions (CIN2 and CIN3) and cervical cancer causally related to HPV types 16 and 18. 10% OF GIRLS HAVE HPV BY THE AGE OF SIXTEEN The BMJ - September 29th 2007 reports that by the age of 16 at least 10% of girls in England have become infected with one or more strains of the human papillomavirus (HPV). Researchers from the Health Protection Agency tested 1483 women and girls aged 10 to 29 years from across England for four strains of the virus: types 6, 11, 16, and 18. Types 6 and 11 are associated with genital warts in particular, while types 16 and 18 are thought to be causative agents in an estimated 70% of cervical cancers. Their findings are reported in the British Journal of Cancer (doi: 10.1038/sj.bjc.6603955). A separate modelling study by the Health Protection Agency indicates that up to 70% of cases of cervical cancer and 95% of cases of genital warts in men and women could be prevented if vaccination against HPV were included. http://www.bmj.com/cgi/content/full/335/7621/632 FDA WARNS ON PEDIATRIC COUGH SUPPRESSANTS The FDA has announced that it will act against the improper use of hydrocodone in pharmaceutical products, especially in over-the-counter cough suppressants marketed for pediatric use. The narcotic is widely used to treat both pain and coughs. Several products containing hydrocodone are marketed for children, and some contain dosing information for children as young as 2 years old, despite the fact that the drug has not been shown to be safe and effective in children under 6. The agency is particularly concerned over similarities in the names of approved and unapproved products. Companies have until the end of October to cease manufacturing and marketing the unapproved pediatric products containing hydrocodone and until the end of the year to cease manufacturing and marketing other unapproved products containing the drug. In addition, the New York Times reports that the FDA is considering an outright ban on OTC cold and cough medications for children younger than 6 years. http://click2.nejm.org/cts/click?q=227%3B66767765%3BNaRuXWV02Xc2acNuinE7pNWLRsADz6JcNzY2S1TuV4I%3D New York Times http://click2.nejm.org/cts/click?q=227%3B66767765%3BNaRuXWV02Xc2acNuinE7pItKRKTYFy%2BuNzY2S1TuV4I%3D ALL ALCOHOLIC BEVERAGES INCREASE BREAST CANCER RISK Breast cancer risk rises with increasing alcohol intake -- regardless of beverage type -- researchers reported on Thursday 27TH September 2007 at the European Cancer Conference. Some 70,000 women provided information about their alcohol intake during health visits from 1978 through 1985. Through 2004, breast cancer was diagnosed in about 4% of them. Compared with women who had reported consuming less than one alcoholic drink a day, those who consumed one to two drinks daily had a 10% increased risk for breast cancer, and those who drank three or more daily had a 30% increased risk. The trend remained significant in analyses stratified by intake of wine, beer, or liquor. The researchers conclude: "These data show the relation of alcohol intake to increased [breast cancer] risk is independent of beverage choice, indicating that ethyl alcohol is the likely culprit." http://click2.nejm.org/cts/click?q=227%3B66764881%3BxrknVOLSSMdoR4DEXtM6AgNRihy6vs5V0PfocQmfCnQ%3D PRESCRIBE EXERCISE FOR TREATMENT OF DIABETES Both aerobic and resistance training help lower hemoglobin A1c levels in patients with type 2 diabetes -- and a combination of the two is even more beneficial -- researchers report in ANNALS OF INTERNAL MEDICINE. Some 250 inactive diabetes patients were randomized to one of four groups: aerobic training, resistance training, both, or no exercise. The active-treatment groups exercised 3 times weekly for 22 weeks. Adjusted absolute HbA1c levels fell significantly with aerobic training (-0.51 percentage point vs. no exercise) and resistance training (-0.38); the combination-exercise group saw additional reductions (-0.46 vs. aerobic training, -0.59 vs. resistance training). Changes in blood pressure and lipids did not differ among the groups. The authors cite research showing a 15% to 20% reduction in major cardiovascular events with a 1-percentage-point decrease in HbA1c. Editorialists note limitations of the current study but conclude: "Failing to prescribe exercise to patients with diabetes is simply unacceptable practice. http://www.annals.org/cgi/content/full/147/6/357 FOOD ADDITIVES ASSOCIATED WITH CHILDHOOD HYPERACTIVITY Common food additives may cause hyperactivity in children in the general population, according to a study published online in THE LANCET (8th September 2007.) In a randomized crossover trial, 137 three-year-olds and 130 eight- or nine-year-olds consumed daily drinks of placebo, mix A (sodium benzoate and artificial food coloring), or mix B (similar to mix A, but with additional food coloring) for 6 weeks. Hyperactivity was evaluated using teacher and parent ratings, direct observation, and a computerized test. Compared with placebo in adjusted analyses, mix A was associated with elevated hyperactivity scores among three-year-olds, while mix B was associated with elevated scores among eight- or nine-year-olds. The authors write, "These findings show that adverse effects are not just seen in children with extreme hyperactivity (ie, ADHD), but can also be seen in the general population and across the range of severities of hyperactivity." http://www.thelancet.com CALCIUM SUPPLEMENTATION REDUCES RISK OF BONE FRACTURE Calcium supplementation alone, or in combination with vitamin D supplementation, reduces the risk of fractures in people aged over 50 by 12%, conclude authors of an article published in THE LANCET – 25th August 2007. Dr Benjamin Tang, University of Western Sydney, Sydney, Australia, and colleagues based their findings on a meta-analysis (a pooled analysis of previous trials) of 17 studies featuring 52 625 people all aged over 50 years, with an average treatment time of 3·5 years. They found that where the compliance rate was high (i.e. patients were sticking to the dosing regimen correctly), there was a 24% fracture risk reduction. The risk reductions were better with calcium doses of over 1200 mg compared with doses of less than 1200 mg (20% versus 6% reduction), and with vitamin D doses of 800 IU (international units) or more than with does less than 800 IU (16% reduction versus 13% reduction). The treatment effect was also greater in individuals who were elderly, lived in institutions, had a low bodyweight, had a low calcium intake, or were at a higher baseline risk than other individuals. The authors believe those in institutions may have benefited more due to assistance complying with the dosing regimen, eg. by nurses making sure patients took their supplements when required. In a separate part to the study, the researchers did a meta-analysis of 23 trials that reported bone density as an outcome, and found that calcium supplementation alone, or in combination with vitamin D supplementation also reduced the rate of bone loss at the hip by 0·54% and at the spine by 1·19%. The authors conclude: “Our meta-analysis has shown that calcium supplementation, alone or in combination with vitamin D, is effective in the preventive treatment of osteoporotic fracture…poor compliance is a major obstacle to obtaining the full benefit of calcium supplementation.” http://www.thelancet.com FDA WARNS AGAINST GIVING COUGH MEDICINE TO CHILDREN UNDER 2 The FDA is warning parents against using cough and cold products in children under age 2; the safety of these products will be reviewed during an October advisory committee meeting. The FDA says that serious complications seen with these drugs appear to be due to overdosage. According to a CDC survey earlier this year, over 1500 children under age 2 were treated during 2004-2005 for adverse effects connected to these drugs, such as hypertension, arrhythmias, and stroke. Three infant deaths were linked to cold and cough medicines during that time -- the infants appeared to have high blood levels of pseudoephedrine. When medicines are warranted in older children, the FDA reminds parents to follow the instructions on the drug label and to seek a clinician's advice if they have questions. If a child's condition worsens, the agency says, the medication should be stopped immediately and the child should be taken to a healthcare provider. http://click2.nejm.org/cts/click?q=227%3B296509%3BU3%2B9uvfCIzBHgte3aRl6OKJZ1pzBEwPqZ3OH5yx1WLc%3D http://click2.nejm.org/cts/click?q=227%3B296509%3BU3%2B9uvfCIzBHgte3aRl6OAgy5eAufy5tZ3OH5yx1WLc%3D http://click2.nejm.org/cts/click?q=227%3B296509%3BU3%2B9uvfCIzBHgte3aRl6OOydv4l2i7fxZ3OH5yx1WLc%3D STUDY SHOWS CHEMOTHERAPY SIDE EFFECTS REDUCED A specially formulated therapeutic honey could help cancer patients who develop Neutropenia, a debilitating side effect associated with chemotherapy and radiation therapy according to a recent study. The peer reviewed study published in the international journal, MEDICAL ONCOLOGY, highlights the beneficial role Life Mel Honey can have in patients experiencing ‘chemotherapy induced neutropenia’1. Life Mel Honey, when administered to patients receiving chemotherapy with a known tendency to developing neutropenia, had a positive effect on the haematopoietic system and stimulated the production of red and white blood cells, haemoglobin and blood platelets. Chemotherapy suppresses the haematopoietic system (blood production), thus impairing the body’s immunity mechanisms, potentially inducing anaemia and limiting the doses of chemotherapy which can be tolerated by patients. Febrile neutropenia, the most serious hematologic toxicity, is associated with the risk of life-threatening infections as well as chemotherapy dose reductions and delays which may compromise treatment outcomes for cancer patients. The study1 assessed the use of Life Mel Honey (LMH) in patients with grade 4 neutropenia receiving chemotherapy for primary or metastatic disease. Traditionally, colony-stimulating factors (CSFs) are used for primary and secondary treatment in patients with grade 4 neutropenia, yet the use of these drugs are expensive and not without side-effects. In the current study, Life Mel Honey was administered to prevent neutropenia and reduce the need for CSFs in patients treated with chemotherapy. Blood counts were performed weekly. There was no recurrence of neutropenia after LMH intake and no need for treatment with CSFs in 40% of patients. LMH was also effective at reducing the incidence of anaemia, which can often be a side effect of chemotherapy, in 64% of patients. No side effects were noted following LMH intake. Further studies with larger numbers of patients are planned and researchers are currently preparing for Stage II clinical trials. http://www.lifemel.co.uk OBESITY SPREADS THROUGH SOCIAL NETWORKS Obesity appears to spread from person to person through social ties, according to a NEW ENGLAND JOURNAL OF MEDICINE study - 26th July 26 2007. The research evaluated a network of about 12,000 people over 32 years. All were members of the Framingham Heart Study. Researchers found, for example, that a person's chances of becoming obese increased by 57% in a given period if a friend became obese, 40% if a sibling did, and 37% if a spouse did. The effects were seen even if the obese acquaintance lived far away. The authors speculate that someone who sees a friend gain weight may regard putting on weight as more acceptable. An editorialist says the work suggests that "friends have an even more important effect on a person's risk of obesity than genes do." http://click2.nejm.org/cts/click?q=227%3B294166%3Bt9NNXS7Nu50%2BSsLr4utkhsxGOcU4qIkTyPDTCkLkJK0%3D CANNABIS COULD INCREASE RISK OF PSYCHOTIC ILLNESS According to research published in THE LANCET – 28TH July 2007 -there is now enough evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life by more than 40%. The issues are also explored in an accompanying Comment and Editorial, concluding: “Governments would do well to invest in sustained and effective education campaigns on the risks to health of taking cannabis.” Cannabis, or marijuana, is the most commonly used illegal substance in most countries, including the UK and USA. Up to 20% of young people now report use at least once per week or heavy use (use on more than 100 occasions). http://www.thelancet.com ASSISTED REPRODUCTION REVIEW The risks of complications both during and after pregnancy achieved through assisted reproduction techniques (ART) are significantly higher than for natural conception, and long term follow-up of children born through ART is needed to fully understand the consequences of these techniques. The issues are addressed in a Review published in THE LANCET – 27th. Researchers in the UK and Germany reviewed data published between 1980 and 2005 on in-vitro fertilisation (IVF) and intracytoplasmic sperm injection, and used 3980 articles to compile their analysis. They focussed mainly on ART single births, since multiple births bring with them their own set of confounding complications. The authors say: “In-vitro fertilisation has been done for nearly 30 years; in developed countries at least 1% of births are from ARTs. These children now represent a substantial portion of the population but little is known about their health.” They say that there are several points for consideration when counseling couples seeking treatment for subfertility. The biggest risk for ART is that multiple births may occur, however a number of other risks are evident from ART techniques. Spontaneous abortion rates are between 20–34% higher for ART couples compared to those spontaneously conceiving—this could be because ART couples are generally older, and also due to endocrine disorders, organic abnormalities and the degree of ovarian stimulation. For couples using ART, the risk of pre-eclampsia occurring is increased by 55%, while there is also an increased risk of still birth (155%), low birthweight (70–77%) very low birthweight (170–200%), or the baby being small for gestational age (40–60% increased risk). Risk of major malformations is 30% higher in babies born to ART couples, regardless of ART technique (although the absolute risk is still small), and there is also a higher risk of cerebral palsy in children born to ART couples, partly because of the risk associated with increased premature birth and partly because some twin pregnancies undergo early in-utero loss, and this event is associated with an enhanced risk of cerebral palsy. The risk of cerebral palsy is lower if single-embryo transfer, rather than multiple-embryo transfer, takes place during the ART. However neurodevelopmentally, mature term babies born after ART progress healthily in relation to naturally conceived children, and no concerns exist about family relationships and psychological issues after ART conception. The authors conclude: “Some of the risks to children born after ART do not arise as a result of the techniques but from the background biology of the subfertile couple... many unknowns exist about the health of children conceived after ART as they grow, which remain to be fully addressed. “Long term follow-up of children born after ART to reproductive age and beyond is necessary.” http://www.thelancet.com BMJ REVIEWS LACTOSE INTOLERANCE An editorial in BMJ: 30-06-07 - gives an overview of lactose intolerance. The authors note that this is common, occurring in around 25% of people of European origin, rising to nearly 100% of those of Asian and native American origin. In infants and people without intolerance, lactose, the primary sugar in milk, is digested by lactase in the intestine mucosal brush border. In most mammals, lactase production declines rapidly after weaning and deficiency is physiological. When lactase is not present, the unabsorbed sugar passes to the colon and is metabolised by colonic bacteria producing gas, and short-chain fatty acids: these cause the clinical syndrome of abdominal cramps, bloating, diarrhea, and flatulence. The degree of symptoms depends on the amount and rate of lactose reaching the colon, and also on the colonic flora; if marked they can be sufficiently disabling as to interfere with daily life. http://www.bmj.com/cgi/content/extract/334/7608/1331 PRO-BI0TIC DRINK HELPS REDUCE ANTIBIOTIC-ASSOCIATED DIARRHOEA Consuming a pro-biotic drink containing Lactobacillus may help older hospitalized patients avoid antibiotic-associated diarrhoea, according to a study published online in the British Medical Journal: 29 – 06 -07. In the manufacturer-supported study, 135 hospitalized patients older than 50 who were prescribed antibiotics were randomized to consume a pro-biotic yogurt drink or a placebo milkshake. The drinks were consumed twice a day concurrent with antibiotic treatment and for a week afterward. Significantly fewer intervention patients than controls developed antibiotic-associated diarrhoea (12% vs. 34%). The number needed to treat (NNT) to prevent one case of antibiotic-associated diarrhoea was 5. The NNT to prevent one case of C. difficile-associated diarrhoea was 6. http://www.bmj.com/cgi/content/full/bmj.39231.599815.55v1 NEW ERA IN RHEUMATOID ARTHRITIS TREATMENT Three new drugs for rheumatoid arthritis (RA) have ushered in a new era of treatment for this difficult and debilitating condition. The findings are reported in a New Drug Class study published early Online in THE LANCET – 18/06/07. Professor Josef Smolen, Division of Rheumatology, Medical University of Vienna, Austria and colleagues did a comprehensive study of the three new drugs—rituximab, abatacept and tocilizumab—and their effects as sole therapies or working in conjunction with existing treatments. They explore the pathogenesis of RA and the various routes for targeting treatments, including new therapeutic strategies, and also provide a comprehensive overview on ways to assess treatment response. http://www.thelancet.com DRAFT GUIDELINES FOR AGE RELATED MACULAR DEGENERATION The National Institute for Health and Clinical Excellence (NICE) has issued draft guidance (Appraisal Consultation Document – ACD) for consultation on the use of ranibizumab (Lucentis™) and pegaptanib (Macugen™) for the treatment of age related macular degeneration. The preliminary recommendations directly from the ACD are provided below: 1. Ranibizumab, within its marketing authorisation, is recommended for the treatment of wet age-related macular degeneration for people who have a confirmed diagnosis of predominantly classic subfoveal choroidal neovascularisation (CNV) (that is, the classic CNV component is 50% or more of the total lesion size), and only for the better-seeing eye, in the following circumstances: • Their best-corrected visual acuity is between 6/12 and 6/96. • There is no permanent structural damage to the central fovea. • The lesion size is less than or equal to 12 disc areas in greatest linear dimension. • There is evidence of recent presumed disease progression (blood vessel growth as indicated by fluorescein angiography, or recent visual acuity changes). 2. Ranibizumab is not recommended for the treatment of people with minimally classic or occult lesions with no classic CNV (that is, the classic CNV component is less than 50% of the total lesion size). 3. Pegaptanib is not recommended for the treatment of wet age-related macular degeneration. 4. People, who are currently receiving pegaptanib for any lesion type, or ranibizumab for minimally classic and occult lesions, should have the option to continue therapy until they and their clinicians consider it appropriate to stop. The key dates for this appraisal are: Closing date for comments: 5 July 2007 Second Appraisal Committee meeting: 9 August 2007 http://guidance.nice.org.uk/page.aspx?o=435391 HPV VACCINE COULD SUBSTANTIALLY REDUCE CERVICAL CANCER Administering Human Papillomavirus Vaccine (HPV) to both sexually active women and those who have never had sex could substantially reduce the incidence of HPV related cervical cancer and precancers, conclude authors of an Article published in The LANCET (2nd June 2007.) Cervical cancer is the second leading cause of death from cancer in women worldwide, and is caused by infection with oncogenic (cancer causing) types of human papillomavirus. For women who have never had sex, the vaccine was 99% effective in stopping cervical cancer (adenocarcinoma in situ), and pre-cancerous lesions. When data from women who could have been exposed was included, the vaccine efficacy was 44%. The researchers enrolled over 20 000 women aged 15–26 from the Americas, Europe and Asia-Pacific in the study. Some 9000 of these were given the full vaccine; around 1200 were given a component of the vaccine and the rest a placebo. A research spokesperson said that questions still had to be answered including how long the vaccine will work, the best age at which to administer it, its cost, and whether men and boys should also be vaccinated. http://www.thelancet.com CALCIUM AND VITAMIN D ASSOCIATED WITH LOWER RISK OF BREAST CANCER The outcomes of a new study, published in THE ARCHIVES OF INTERNAL MEDICINE, suggest that higher intakes of calcium and vitamin D may be associated with a lower risk of developing premenopausal breast cancer. The likely apparent protection in premenopausal women may be more pronounced for more aggressive breast tumours. In the study, total calcium and vitamin D intake in relation to breast cancer incidence among 10,578 premenopausal and 20,909 postmenopausal women 45 years or older, who were free of cancer and cardiovascular disease at baseline in the Women's Health Study were prospectively evaluated. During an average of 10 years of follow-up, 276 premenopausal and 743 postmenopausal women had a confirmed diagnosis of incident invasive breast cancer. Higher intakes of total calcium and vitamin D were moderately associated with a lower risk of premenopausal breast cancer. http://archinte.ama-assn.org/cgi/content/abstract/167/10/1050 NHS RANKED BEST HEALTH SYSTEM AMONG LEADING NATIONS BMJ NEWS (26TH May 2005) reports on a survey of health systems in six industrialised nations (Australia, Canada, Germany, New Zealand, the United Kingdom (UK), and the United States (US)) carried out by the Commonwealth Fund. The UK was ranked first overall and scored highest on quality, efficiency, and equity, however, for the third time consecutively, the US came last in the survey. The UK and US scored poorly in terms of “healthy lives” (numbers of preventable deaths and life expectancy), Australia ranked the highest for this indicator. Although the US came last on the five dimensions of a high performance health system: quality, access, patients' safety, efficiency, equity, and healthy lives, it performed the best in terms of preventative care. The survey also found the US lagged behind other countries in adopting information technology and national policies that promote quality improvement. The survey found that the US spent only $0.43 per person on health information technology in 2005, whereas in the UK the figure was $192 per person. The report, (“Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health http://www.bmj.com/cgi/content/extract/334/7603/1078-a DOCTOR AT SEA IN THE BMJ Maudsley hospital clinician, Dr Emma Stanton embarked September 2005 crewing the Sailing Yacht LIVERPOOL in the Clipper Round the World Yacht Race 2005-2006. Her craft raced against ten yachts, each manned by 15 crew and a skipper. While at sea, she carried out some original research into group dynamics subjecting her fellow crew members to regular assessments. Her report of the experience is in the BMJ - 21st April 2007 and can be viewed by clicking on the link below http://careerfocus.bmj.com/cgi/content/full/334/7597/138 CHONDROITIN INEFFECTIVE FOR OSTEOARTHRITIS Chondroitin does not appear to reduce joint pain in people with osteoarthritis and its use should be discouraged, concludes a study in the Annals of Internal Medicine. In their meta-analysis of 20 trials comparing chondroitin with either placebo or no treatment, the authors found evidence of benefit only in small, methodologically weak studies. "Large-scale, methodologically sound trials indicate that the symptomatic benefit is minimal to nonexistent," they conclude, and "its use [in advanced disease] should be discouraged." However, because researchers found no adverse effects associated with chondroitin use, an editorialist did not completely agree: "If patients say that they benefit from chondroitin, I see no harm in encouraging them to continue taking it as long as they perceive a benefit." http://www.annals.org/cgi/content/full/146/8/611 FDA APPROVES HUMAN VACCINE FOR AVIAN INFLUENZA The FDA yesterday approved a human vaccine against the H5N1 influenza virus, marking the first such approval in the US. In a press release the agency said that, should H5N1 develop the ability to spread readily from person to person, "the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain of the virus could be developed and produced." The vaccine will be kept in a federal stockpile and available only through public health officials; it is approved for those 18 to 64 who are at increased risk for H5N1 exposure. http://www.fda.gov/cber/label/h5n1san041707LB.pdf SELF MANAGEMENT TRAINING FOR PATIENTS The Department of Health is enabling more people with long-term illnesses to have greater control over their conditions by establishing a social enterprise organisation called The Expert Patients Programme Community Interest Company (EPP CIC). Primary Care Trusts (PCTs) will be able to commission the EPP CIC to run self-management courses for patients as well as training volunteers to run local courses. Early findings suggest that through better self-management, A&E attendances have been reduced by over 15 per cent for people who have attended an EPP course. Health Minister Rosie Winterton believes that this is an excellent opportunity for PCTs to help patients in their local area to better manage long-term conditions. "By commissioning these courses, they are investing in self-care and empowering patients, increasing social capital and improving community health. Knowing how to best manage a long-term condition reduces the need for expensive emergency care - this is better for patients and for the local NHS." The Expert Patient Programme Community Interest Company began operating on 1st April 2007, with the aim of increasing the number of course places every year from 12,000 to 100,000 by 2012. A SEASIDE PRACTICE - Tales of a Scottish Country Doctor A delightful autobiography of his life as a Scottish country doctor, ABD Member, GP Tom Smith, has just published an excellent read – A Seaside Practice – Tales of a Scottish Country Doctor. Nothing in his medical training could have prepared him for his first job as a young GP in Collintrae, a small fishing village on the south west coast of Scotland. Three villages along the coast road came under his care, covering six hundred square miles (that’s three people per square mile), eighteen hundred people and a hundred thousand sheep. Amongst some of the extraordinary cases that he comes up against in his first few years are the reclusive Mad Maggie of Muck Bridge cottage, who turned out not to be mad at all, farmer ‘Chloroform Campbell’ who’d actually knocked himself out, the baker with nine lives, and a gaggle of giggling nuns. Heartwarming and gloriously eccentric, Dr Tom’s stories capture the beauty of the Scottish lowlands, the joys and sorrows of its inhabitants, and the richly rewarding experiences of his life there. Published by Short Books, £12.99. April 5 2007. To contact Dr Smith, please click here to email for details. FISH OIL REDUCES NONFATAL CORONARY EVENTS IN HYPERCHOLESTEROLEMIA Consumption of the fish-oil component eicosapentaenoic acid (EPA) lowers rates of unstable angina and nonfatal coronary events in patients with hypercholesterolemia, researchers report in THE LANCET – 31-03-2007. In an open-label, industry-sponsored trial, researchers randomized some 19,000 Japanese patients with total cholesterol levels at 6.5 mmol/L (roughly 250 mg/dL) or greater to receive either 1800 mg of EPA a day plus a statin, or statin alone. Five-year cumulative rates of major coronary events were 2.8% in the EPA group and 3.5% in controls (relative risk reduction, 19%). Rates of sudden cardiac and coronary death did not differ between the groups. A commentary writer calls the results "unexpected," and says that "we must curb our infatuation with downstream risk factors and treatments, and focus on the fundamental risk factors for cardiovascular disease: dietary habits, smoking, and physical activity." http://www.thelancet.com/journals/lancet/article/PIIS0140673607605273/abstract £1/2 MILLION IDEAS INITIATIVE TO TACKLE MENTAL HEALTH PROBLEMS The National Endowment for Science, Technology and the Arts (NESTA) in co-operation with the Mental Health Foundation (MHF) and other key organisations in mental health have launched a £1/2 million initiative to identify innovative ways of tackling mental health problems. They are calling upon front-line workers, carers and people with direct experience of mental distress to come forward with their ideas. The project - Innovations in Mental Health - will encompass all aspect of mental health, across all life stages and in any setting. Projects are likely to range from ways to break down the stigma of mental illness to encouraging the involvement of users in re-designing their own care. They may focus on new and improved processes and services, but could also take the shape of new products or technologies. NESTA is particularly interested in ideas that involve collaboration between different disciplines or different areas of mental health practice. Applicants are encouraged to apply online at http://www.nesta.org.uk/challenges. The deadline for applications is 5pm on Friday 18 May 2007. LEADING MEDICAL EXPERTS CONDEMN MTAS Protesting vehemently against the debacle of the Medical Training Application Service (MTAS), Modernising Medical Careers (MMC), and the Postgraduate Medical Education and Training Board (PMETB), a group of leading medical academic experts from several top-ranking UK universities and institutions, including THE LANCET, have co-authored an early online Comment – http://www.thelancet.com The experts draw attention to an online poll of consultants and doctors’ views and wishes about MMC and MTAS. 87% of the poll respondents wish the current round of interviews to be aborted, 85% wish a second round suspended until there are agreed major changes, and only 13% indicate a belief that MMMC offers improvement over the current system of training. Calling for individual Medical Colleges to ballot their members and for Deans and members of Appointment Committees to support a ballot, the authors conclude: “Maybe MTAS really is a short-term problem that can be fixed, but it has dramatically opened the window to the grave short-comings of MMC and the PMETB. We are not against changes in medical training or appointments, but these changes must be undertaken by experts, and with consultation and humanity”. TYPE 1 DIABETES IN CHILDREN HAS SOARED IN 20 YEARS Data from a study conducted by Bristol University and presented at Diabetes UK's annual conference (March 2007) indicate that the number of young children with type 1 diabetes has risen dramatically in the last 20 years. The study, which focused on 2.6 million people in and around the Oxford region between 1985 and 2004, found that the number of under-15s with the condition almost doubled during the study period and the number of under-fives with the condition increased five-fold. Diabetes UK said that other studies have revealed similar rises, suggesting the trend is true for the whole of the UK. The charity estimated that at least 20,000 children of school age in the UK have type 1 diabetes. The lead researcher of the study said that the rate of this disease in childhood was increasing all over Europe, particularly in the very young, but the increase was too steep to be put down to genetic factors alone. Possible reasons, she suggests, include changes in the environment, children’s diets, less breastfeeding, and less exposure to germs affecting the development of their immune systems. The director of care, information and advocacy services for Diabetes UK added: "Whilst 10 to 14-year-olds remain the largest group for diagnosis, the rise in cases found in children under five is worrying." http://www.diabetes.org.uk NICE SAYS NO TO LUNG CANCER TREATMENT The government's health watchdog has ruled that the lung cancer pill Tarceva will not be made available on the NHS in England and Wales. According to the National Institute for Health and Clinical Excellence (NICE), the cancer treatment is of limited use and would not be cost effective. As a result, sufferers of non small cell lung cancer, the most common type of the disease, will be forced to pay around £1,630 per month for private treatment if they wish to take the drug. Manufacturer Roche has announced its intention to appeal against Nice's final decision, describing it as "perverse and flawed", Reuters news agency reports. Clinical trials of the cancer treatment have revealed that it reduces the symptoms of non small cell lung cancer and also increases one year survival rates by 41 per cent. The drug was licensed in Britain in 2005 and has been recommended for use in Scotland since last year, meaning that English and Welsh patients are once again being denied a cancer treatment that is available north of the border. http://www.cancerhelp.org.uk/help/default.asp?page=10302 FURY OVER TREATMENT OF YOUNG DOCTORS A new government scheme, Modernising Medical Careers (MMC), has been met with fierce criticism from doctors and NHS staff. They fear that it will result in a massively understaffed workforce and predict a shortage of doctors as early as August 2007 resulting in critically compromised patient care. Accusations of fundamental errors, incompetence and outright corruption have plagued MMC. Grassroots junior doctors have now begun an investigation into the government’s reforms of medical training. http://www.mmc360.com is a website designed to gather growing evidence of the failings of Modernising Medical Careers and present the data to the UK public, highlighting the huge implications on the NHS and on patient care. GUIDELINES FOR TREATING CHLAMYDIA TRACHOMATIS The British Association of Sexual Health and HIV (BASHH) has published a UK national guideline for the diagnosis and management of genital tract infection with Chlamydia trachomatis. http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=10176 TRANSDERMAL DELIVERY MAY CUT CLOT RISK OF ESTROGEN Transdermal estrogen therapy may not pose the same risk for venous thromboembolism as oral estrogen therapy does, according to a study in CIRCULATION. The French case-control study compared 271 postmenopausal women 45 to 70 years old who had a first episode of idiopathic venous thromboembolism with 610 controls. After adjustment for potential confounders, women who took oral estrogen were four times as likely to have had a venous thromboembolism as those who did not take hormones. But women who used transdermal estrogen had about the same risk as nonusers. The study also suggests that norpregnane derivatives are thrombogenic, while micronized progesterone and pregnane derivatives appear not to be. http://circ.ahajournals.org/cgi/content/abstract/115/7/840 LANCET PRAISES BRANSON'S UMBILICAL CORD BLOOD BANK THE LANCET – 10/02/2007 praises in its lead Editorial any attempt to increase the available pool of umbilical cord blood cells, which are otherwise discarded. Although Richard Branson’s plan to branch out into umbilical cord blood banking has been criticized by health-care staff and medical colleges, the editorial is in favour of the Virgin Health Bank because it differs from other similar enterprises by offering a public/private approach. One-fifth of the cord blood sample will be stored for private use and the rest will be donated to the public part of the bank, which is accessible to anyone who needs it at no cost. In addition Richard Branson has pledged to donate his 50% of proceeds from the Bank to initiatives involved in realizing the potential of cord blood stem cells. The Editorial goes on to criticise the unsupportive stance taken by National Health Service staff and the Royal College of Obstetricians and Gynaecologists. It concludes: “Despite all its apparent emphasis on so-called patient choice, the UK Government has changed a once great service into a monolithic outdated business without the capability to fully embrace such exciting new initiatives as cord blood banking.” http://www.thelancet.com/journals/lancet/article/PIIS0140673607602037/fulltext LAVENDER & TEA TREE OILS LINK TO PREPUBERTAL GYNECOMASTIA Topical use of lavender or tea tree oils may lead to prepubertal gynecomastia, according to a report in the New England Journal of Medicine (1st February 2007.) Researchers present the case histories of three boys -- aged 4, 7, and 10 -- with prepubertal gynecomastia; all were otherwise healthy. None of the boys had been exposed to known exogenous endocrine disruptors such as medications, oral contraceptives, marijuana, or soy products, but each was using lotion, soap, shampoo, balm, or styling gel containing lavender oil, and in some cases tea tree oil, when gynecomastia developed. Each boy's symptoms resolved after such use was discontinued, and subsequent cell-culture studies showed both oils to have estrogenic and antiandrogenic activities. The researchers comment “Physicians should be aware of the possibility of endocrine disruption and should caution patients about repeated exposure to any products containing these oils.” http://content.nejm.org/cgi/content/abstract/356/5/479 PROMISING CANCER TREATEMENT TOO CHEAP TO BE WORTHWHILE? A report in NEW SCIENTIST – 20 Jan 2007 – comments on a surprising conundrum – can a cancer treatment be too cheap? It seems that it can. New US research indicates that dichloroacetate (DCA) an odourless, colourless, inexpensive, relatively non-toxic, small molecule could be used as an effective treatment for many forms of cancer. Sadly, because it is not a new drug it cannot be patented and funding for human cancer trials is unlikely to be forthcoming from usual sources. Dr. Evangelos Michelakis, a professor at the University of Alberta Department of Medicine, has shown that dichloroacetate (DCA) causes regression in several cancers, including lung, breast, and brain tumors. Michelakis and his colleagues, including post-doctoral fellow Dr. Sebastian Bonnet, have published the results of their research in the journal CANCER CELL. Scientists and doctors have used DCA for decades to treat children with inborn errors of metabolism due to mitochondrial diseases. Mitochondria, the energy producing units in cells, have been connected with cancer since the 1930s, when researchers first noticed that these organelles dysfunction when cancer is present. Until recently, researchers believed that cancer-affected mitochondria are permanently damaged and that this damage is the result, not the cause, of the cancer. But Michelakis questioned this belief and began testing DCA, which activates a critical mitochondrial enzyme, as a way to "revive" cancer-affected mitochondria. The results astounded him. Michelakis and his colleagues found that DCA normalized the mitochondrial function in many cancers, showing that their function was actively suppressed by the cancer but was not permanently damaged by it. More importantly, they found that the normalization of mitochondrial function resulted in a significant decrease in tumor growth both in test tubes and in animal models. Also, they noted that DCA, unlike most currently used chemotherapies, did not have any effects on normal, non-cancerous tissues. "I think DCA can be selective for cancer because it attacks a fundamental process in cancer development that is unique to cancer cells," Michelakis said. "Cancer cells actively suppress their mitochondria, which alters their metabolism, and this appears to offer cancer cells a significant advantage in growth compared to normal cells, as well as protection from many standard chemotherapies. Because mitochondria regulate cell death--or apoptosis--cancer cells can thus achieve resistance to apoptosis, and this appears to be reversed by DCA." "One of the really exciting things about this compound is that it might be able to treat many different forms of cancer, because all forms of cancer suppress mitochondrial function; in fact, this is why most cancers can be detected by tests like PET (positron emission tomography), which detects the unique metabolic profile of cancer compared to normal cells," added Michelakis, the Canada Research Chair in Pulmonary Hypertension. Another encouraging thing about DCA is that, being so small, it is easily absorbed in the body, and, after oral intake, it can reach areas in the body that other drugs cannot, making it possible to treat brain cancers, for example. Also, because DCA has been used in both healthy people and sick patients with mitochondrial diseases, researchers already know that it is a relatively non-toxic molecule that can be immediately tested in patients with cancer. Source: University of Alberta http://www.depmed.ualberta.ca/dca/ FOLATE SUPPLEMENT IMPROVES COGNITIVE FUNCTION IN THE ELDERLY? In contrast to the findings of a recent systematic review in The Arch International Medicine, a long-term controlled trial has found that a folate supplement improved retention of cognitive function in a group of elderly people. The study, published in THE LANCET – 20-01-07 - was primarily designed to investigate the effects of folate and vitamin B12 on atherosclerosis markers, however cognitive function was a secondary endpoint. The authors note that epidemiological research suggests a link between folate status and cognitive function, and comment that previous trials have generally been small and short-term, or have used imprecise measures of function. They therefore investigated the impact of 800microg folic acid daily for three years on a range of measures of cognitive function, including areas known to decline as a result of ageing. http://www.thelancet.com/journals/lancet/article/PIIS0140673607601093/fulltext Copies of medical papers are for Members only, Please click here to enquire about Membership |
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