UK scientists have developed a new type of brain scan that only takes 15 minutes and can diagnose autism in adults with over 90 per cent accuracy: they hope to develop it so it can be used to screen children for autism spectrum disorders.Study leader Dr Christine Ecker, a Lecturer in the Department of Forensic and Neurodevelopmental Sciences from the Institute of Psychiatry (IoP) at King’s College London, and supervisor Dr Declan Murphy, Professor of Psychiatry and Brain Maturation at the IoP, and colleagues wrote a paper about their pioneering work that is to be published in The Journal of Neuroscience today, 11th of August.

Using an MRI scanner and 3D imaging techniques, Ecker, Murphy and colleagues assessed the structure, shape and thickness of of the brain’s grey matter, looking at key measurement markers of Autism Spectrum Disorder (ASD).They studied the brains of 59 male adults aged between 20 and 68 years. 20 of the participants had ASD and 19 had ADHD (Attention Deficit Hyperactivity Disorder); the other 20 were healthy controls.The participants first underwent traditional diagnostic assessment, which included taking an IQ test, being interviewed by a psychiatrist and having a physical exam and blood test.

The researchers then tested all the participants with the new brain scan and 3D image method and found it was highly effective in identifying the individuals who had been diagnosed with autism.They concluded that the method provided a rapid diagnostic tool based on biological markers to detect autism.Anyone who has experience of ASD knows the huge difference having a rapid test that uses physiological markers as opposed to personality traits to assess whether a person has ASD would make, as Ecker explained to the press:

“It could help to alleviate the need for the emotional, time consuming and expensive diagnosis process which ASD patients and families currently have to endure.”

She said she and her colleagues were now looking forward to testing the method for helping children.

Murphy explained that people with autism are affected in different ways:

“Some can lead relatively independent lives while others need specialist support or are so severely affected they cannot communicate their feelings and frustrations at all.”

“Simply being diagnosed means patients can take the next steps to get help and improve their quality of life,” he said.

However, he cautioned that there are also ethical implications, for instance people who may not suspect they have autism must be handled carefully and sensitively should this method become part of standard clinical practice.The study comes under the auspices of the AIMS (Autism Imaging Multicentre Study) Consortium, which is funded by the UK’s Medical Research Council, with additional assistance from the Wellcome Trust and National Institute for Health Research (NIHR).
Professor Christopher Kennard, who chairs the MRC’s Neuroscience and Mental Health funding board, spoke of the impact that investing in this new method, and others like it, can make:

“We know that an investment like this can dramatically affect the quality of life for patients and their families.”

“The more we understand about the biological basis of autism, the better equipped we will be to find new ways of treating those affected in the future,” he added.

About 1 per cent of the UK population, in the region of half a million people, are affected by Autism Spectrum Disorder (ASD), a lifelong and disabling condition caused by abnormalities in brain development.More men than women have ASD (the ratio is one woman to every four men) and current diagnostic methods rely heavily on information gleaned from personal accounts given by patients’ close friends and relatives. The process takes a long time involving many experts to interpret the information.

Sources: King’s College London, MRC.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today

The expert says these latest findings reiterate what the American Heart Foundation (AHA) advised in 2008 – that compression only CPR is recommended for bystanders who are not properly trained or who are not at ease with performing mouth-to-mouth on individuals who collapsed from sudden cardiac arrest (sudden, unexpected loss of heart function, breathing and consciousness). In the NEJM editorial, published on July 29th, Myron (Mike) Weisfeldt, M.D., a cardiologist, physician in chief at The Johns Hopkins Hospital and director of the Department of Medicine at Hopkins’ School of Medicine, says “less may be better” in CPR, calling the findings straightforward, practical and potentially life-saving.

The two studies looked at over 3,000 individuals (males and females) who needed CPR between 2004 and 2009. The researchers found that survival rates for patients who received just chest compressions from bystanders was similar to those who received both chest compressions and rescue breathing (mouth-to-mouth).

The bystanders in all cases were told by phone during a 911 call how to do CPR. One study showed survival rates after one month of 8.7 percent and 7 percent, respectively, while the other showed survival rates at time of hospital discharge of 12.5 percent and 11 percent. The researchers say the numbers were statistically the same.Weisfeldt, a past president of the AHA (1989-1990), said:

It is very important to understand that the patients in this study were adults and that for most children who suffer cardiac arrest, such as drowning victims, we must do rescue breathing.

He also notes that there are adults with breathing-related causes of sudden death where rescue breathing should be performed, including patients with sudden, acute heart failure, severe chronic lung disease, or acute asthma, and cardiac arrest. However, Weisfeldt says:

“For people who are not well-trained or who are looking for a simple way to help save a life, chest compressions only, at least until the emergency care unit arrives, can be life saving, even without rescue breathing.

According to Weisfeldt, these latest finding may lead to stronger national guidelines on how passers-by should perform CPS. He adds that an update is expected to be announced in November in Chicago at an AHA annual meeting. Guidelines will probably recommend a steady 100 chest compressions per minute with less emphasis on rescue breathing.Weisfeldt stresses that both latest studies and previous animal studies had revealed that hands-only CPR worked best for specific types of cardiac arrest, typically instances resulting from an abnormal heart rhythm (and requiring defibrillation).

Further research is needed to determine whether a combination of CPR with mouth-to-mouth is better at saving lives in certain types of cardiac arrest, and also to find out whether the public can be trained to tell one type of heart attack from another.

CPR performed by bystanders is known to almost double the survival chances of patients suffering from sudden cardiac arrest.

Source: The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System

The US FDA (Food and Drug Administration) has approved vaccines for the 2010-2011 USA influenza season, protecting against three strains of influenza, including the H1N1 virus which caused the 2009 pandemic.In 2009, because the H1N1 virus appeared after seasonal vaccine production commenced, two separate vaccines were required to protect against the seasonal flu and the 2009 H1N1 pandemic flu virus. The FDA says that only one vaccine is needed for this year.The CDC (Centers for Disease Control and Prevention ) informs that between 5% and 20% of the American population develops influenza annually, resulting in over 200,000 hospitalizations from related complications and about 36,000 deaths.

Karen Midthun, M.D., acting director of FDA’s Center for Biologics Evaluation and Research, said:

The best way to protect yourself and your family against influenza is to get vaccinated every year. The availability of a new seasonal influenza vaccine each year is an important tool in the prevention of influenza related illnesses and death.

The FDA says that it is vital that health care personnel be vaccinated for their own protection, as well as people they come into contact with, such as patients, their family, and the community.The brand names and manufacturers for the upcoming season’s vaccines are:

* Afluria (CSL Limited)
* Agriflu (Novartis Vaccines and Diagnostics)
* Fluarix (GlaxoSmithKline Biologicals)
* FluLaval (ID Biomedical Corporation)
* FluMist (MedImmune Vaccines Inc. )
* Fluvirin (Novartis Vaccines and Diagnostics Limited)
* Fluzone and Fluzone High-Dose (Sanofi Pasteur Inc.)

Each year, experts from FDA, World Health Organization, CDC, and other institutions study virus samples and patterns collected worldwide to identify strains likely to cause the most illness during the upcoming season. Based on that information and the recommendations of FDA’s Vaccines and Related Biological Products Advisory Committee, manufacturers included the respective three strains in the 2010-2011 vaccines. The closer the match between the circulating strains and the strains in the vaccine, the better the protection against influenza disease.

Vaccines for the 2010-2011 seasonal influenza contain the following strains:

* A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus)
* A/Perth /16/2009 (H3N2)-like virus
* B/Brisbane/60/2008-like virus

There is a chance that a match between predicted virus strains and the ones that eventually circulate is not perfect. Nevertheless, even if the vaccine and the circulating strains are not a perfect match, the vaccine may help infected patients experience milder symptoms and have a lower risk of complications, the FDA informs.

The FDA writes that seasonal influenza vaccines have a long and successful track record of safety and effectiveness in the USA.

The labeling for one vaccine, CSL Limited’s Afluria, has undergone changes this season to inform health care providers about an increased incidence of fever and febrile seizure, which was seen in young children, mainly those younger than 5 years, following administration of the 2010 Southern Hemisphere formulation of CSL’s influenza vaccine. The Southern Hemisphere influenza season occurs prior to that of the Northern Hemisphere. CSL Limited will not be supplying the United States with the 0.25 milliliter single-dose, prefilled syringes, which are used in very young children. The 0.5 milliliter single-dose, prefilled syringes and 5 milliliter multi-dose vials will be distributed.

FDA is requiring CSL Limited to conduct a study of Afluria in children to obtain additional information regarding the febrile events that were seen in the Southern Hemisphere.CDC has published recommendations for annual influenza vaccination to include all people aged 6 months and older. The expanded recommendation is to take effect in the 2010-2011 influenza season. The Advisory Committee on Immunization Practices (ACIP), which advises the CDC on vaccine issues, voted on the new recommendation during its February 24, 2010 meeting in Atlanta.Prior recommendations for seasonal influenza vaccination focused on vaccination of persons at increased risk for complications from influenza including people with underlying health conditions, children 6 months through 18 years of age, and close contacts of high risk persons among others.

The new recommendations can be found at here.

Source: FDA

Copyright: Medical News Today

Understanding of mouse immune-system response to specific fetal antigens also may provide insight into issues that arise during human pregnancies.The concept of pregnancy makes no sense – at least not from an immunological point of view. After all, a fetus, carrying half of its father’s genome, is biologically distinct from its mother. The fetus is thus made of cells and tissues that are very much not “self” – and not-self is precisely what the immune system is meant to search out and destroy.Women’s bodies manage to ignore this contradiction in the vast majority of cases, making pregnancy possible. Similarly, scientists have generally paid little attention to this phenomenon – called “pregnancy tolerance” – and its biological details.

Now, a pair of scientists from the California Institute of Technology (Caltech) have shown that females actively produce a particular type of immune cell in response to specific fetal antigens – immune-stimulating proteins – and that this response allows pregnancy to continue without the fetus being rejected by the mother’s body.
Their findings were detailed in a recent issue of the Proceedings of the National Academy of Sciences (PNAS).

“Our finding that specific T regulatory cells protect the mother is a step to learning how the mother avoids rejection of her fetus. This central biological mechanism is important for the health of both the fetus and the mother,” says David Baltimore, Caltech’s Robert Andrews Millikan Professor of Biology, recipient of the 1975 Nobel Prize in Physiology or Medicine, and the principal investigator on the research.

Scientists had long been “hinting around at the idea that the mother’s immune system makes tolerance possible,” notes paper coauthor Daniel Kahn, a visiting associate in biology at Caltech, and an assistant professor of maternal-fetal medicine at the University of California, Los Angeles (UCLA). What they didn’t have were the details of this tolerance – or proof that it was immune-related.Now they do. To pin down those details, the two scientists began looking at the immune system’s T regulatory cells (Tregs) in a strain of inbred mice that are all genetically identical – except for one seemingly tiny detail. Male mice – including male fetuses – carry on their cells’ surfaces a protein known as a “minor transplantation antigen.” Female mice lack this antigen.

Under normal circumstances, this antigen’s existence isn’t a problem for the male fetuses because the pregnancy tolerance phenomenon kicks in and protects them from any maternal immune repercussions.

To demonstrate the role of Tregs, Baltimore and Kahn used a drug to selectively target and destroy the cells. If the Tregs were indeed the source of pregnancy tolerance, they reasoned, their destruction would give the immune system free rein to go after the antigen-laden fetuses.

“In this case,” says Kahn, “we knew the only possible immune response would be against the males – that the males would be at risk.”

Understanding of mouse immune-system response to specific fetal antigens also may provide insight into issues that arise during human pregnancies.The concept of pregnancy makes no sense – at least not from an immunological point of view. After all, a fetus, carrying half of its father’s genome, is biologically distinct from its mother. The fetus is thus made of cells and tissues that are very much not “self” – and not-self is precisely what the immune system is meant to search out and destroy.Women’s bodies manage to ignore this contradiction in the vast majority of cases, making pregnancy possible. Similarly, scientists have generally paid little attention to this phenomenon – called “pregnancy tolerance” – and its biological details.Now, a pair of scientists from the California Institute of Technology (Caltech) have shown that females actively produce a particular type of immune cell in response to specific fetal antigens – immune-stimulating proteins – and that this response allows pregnancy to continue without the fetus being rejected by the mother’s body.

Their findings were detailed in a recent issue of the Proceedings of the National Academy of Sciences (PNAS).

“Our finding that specific T regulatory cells protect the mother is a step to learning how the mother avoids rejection of her fetus. This central biological mechanism is important for the health of both the fetus and the mother,” says David Baltimore, Caltech’s Robert Andrews Millikan Professor of Biology, recipient of the 1975 Nobel Prize in Physiology or Medicine, and the principal investigator on the research.

Scientists had long been “hinting around at the idea that the mother’s immune system makes tolerance possible,” notes paper coauthor Daniel Kahn, a visiting associate in biology at Caltech, and an assistant professor of maternal-fetal medicine at the University of California, Los Angeles (UCLA). What they didn’t have were the details of this tolerance – or proof that it was immune-related.

Now they do. To pin down those details, the two scientists began looking at the immune system’s T regulatory cells (Tregs) in a strain of inbred mice that are all genetically identical – except for one seemingly tiny detail. Male mice – including male fetuses – carry on their cells’ surfaces a protein known as a “minor transplantation antigen.” Female mice lack this antigen.Under normal circumstances, this antigen’s existence isn’t a problem for the male fetuses because the pregnancy tolerance phenomenon kicks in and protects them from any maternal immune repercussions.To demonstrate the role of Tregs, Baltimore and Kahn used a drug to selectively target and destroy the cells. If the Tregs were indeed the source of pregnancy tolerance, they reasoned, their destruction would give the immune system free rein to go after the antigen-laden fetuses.

“In this case,” says Kahn, “we knew the only possible immune response would be against the males – that the males would be at risk.”

Indeed they were. When Baltimore and Kahn looked at the offspring of mice who’d been treated with the toxin, they found that fewer of the male fetuses survived to birth; those males that did survive were of significantly lower birthweight, presumably because of the inflammation caused by the mother’s immune response to that single antigen.

“These T cells are functioning in an antigen-specific manner,” Kahn notes. “In other words, their function requires the presence of the specific fetal antigens.”

In their studies of these animals, the scientists also found that pregnancy tolerance “develops actively as a consequence of pregnancy,” says Kahn. “The mice are not born with it.” Indeed, virgin mice showed no signs of these pregnancy-specific Treg cells. Conversely, the cells were found in larger numbers in those individual mice that had given birth to more male babies, with the level of Treg cells increasing with the number of male births.

The next step, Kahn adds, is to look at Tregs and their role in pregnancy tolerance in humans – a line of research that may lead to new insights into such pregnancy-related conditions as preeclampsia, in which high blood pressure and other symptoms develop in the second half of pregnancy. Preeclampsia is a major cause of maternal mortality around the world.

“There’s a lot to be learned,” he says. “Pregnancy is often ignored in research because it’s usually successful, and because – from an immunologic standpoint – it has such complexity. Until now, it’s been difficult to grab a handle on how the immunology of pregnancy really works.”

The work described in the PNAS article, “Pregnancy induces a fetal antigen-specific maternal T regulatory cell response that contributes to tolerance,” was supported in part by a research grant from the Skirball Foundation. Kahn is supported by the National Institutes of Health’s Building Interdisciplinary Research Careers in Women’s Health Center at UCLA.

Source: California Institute of Technology

Cells from frozen human blood samples can be reprogrammed to an embryonic-stem-cell-like state, according to Whitehead Institute researchers. These cells can be multiplied and used to study the genetic and molecular mechanisms of blood disorders and other diseases.The research is reported in the July 2 issue of Cell Stem Cell.

To date, most cellular reprogramming has relied on skin biopsy or the use of stimulating factors to obtain the cells for induction of pluripotency. This work shows for the first time that cells from blood samples commonly drawn in doctor’s offices and hospitals can be used to create induced pluripotent stem (iPS) cells.Using blood as a cell source of iPS cells has two major advantages.

“Blood is the easiest, most accessible source of cells, because you’d rather have 20 milliliters of blood drawn than have a punch biopsy taken to get skin cells,” says Judith Staerk, first author of the Cell Stem Cell paper and a postdoctoral researcher in the lab of Whitehead Founding Member Rudolf Jaenisch.Also, blood collection and storage is a well established part of the medical system.

“There are enormous resources-blood banks with samples from patients-that may hold the only viable cells from patients who may not be alive anymore or from the early stage of their diseases,” says Jaenisch, who is also a professor of biology at MIT. “Using this method, we can now resurrect those cells as induced pluripotent stem cells. If the patient had a neurodegenerative disease, you can use the iPS cells to study that disease.”

iPS cells are reprogrammed from an adult state to an embryonic stem-cell-like state by inserting four reprogramming genes into the adult cells’ DNA. These reprogramming factors convert the adult cells, with defined cell functions, into much more flexible iPS cells. iPS cells can then be nudged to divide repeatedly or turn into almost any cell type found in the body, allowing scientists to create large amounts of the specific cells needed to study a disease, such as dopamine-producing neurons for Parkinson’s disease research.Unlike other cell types, human blood cells had proven extremely difficult to convert into iPS cells. Working with frozen blood samples similar to those found in a blood bank, Staerk found that she could convert the blood cells by inserting a “cassette” of the reprogramming factors end to end, rather than inserting each of the factors separately.

Not all of the cells in the blood samples were converted to iPS cells. Blood is composed of red cells that carry oxygen throughout the body, white cells that are part of the immune system, and platelets that clot the blood after an injury. Because red blood cells and platelets lack nuclei containing DNA, they cannot be converted to iPS cells. The only white bloods cells converted to iPS cells were T cells and a few myeloid cells. B cells failed to reprogram, most likely because the experiment’s environment lacked the chemicals needed for successful B-cell conversion.

Staerk is particularly interested in using these iPS cells to study blood diseases.

“With this method, you could reprogram blood samples from patients where the underlying cause of their diseases is not known, and get cell numbers large enough to screen for genetic factors and study the molecular mechanisms underlying the blood disorders,” she says. “That’s a big advance, especially if the patient is not alive anymore and new material cannot be obtained.”

This research was supported by the National Institutes of Health (NIH) and the Human Frontier Science Program (HFSP).

Rudolf Jaenisch’s primary affiliation is with Whitehead Institute for Biomedical Research, where his laboratory is located and all his research is conducted. He is also a professor of biology at Massachusetts Institute of Technology.

Source: Whitehead Institute for Biomedical Research

A panel of US experts, including specialists in cancer, exercise training, fitness and obesity are urging cancer patients and survivors to avoid inactivity, even while undergoing treatment, as more and more research shows that continuing to exercise has a significant impact on their physical functioning and quality of life.

This is the message embodied in a new set of guidelines from a panel of 13 experts that the American College of Sports Medicine (ACSM) convened last year to consider what exercise advice to give cancer patients and survivors.

The guidelines appear in the July issue of the journal Medicine & Science in Sports & Exercise and follow the 2008 release of the Physical Activity Guidelines for Americans, published by the US Department of Health and Human Services. The lead author is Dr Kathryn Schmitz of the University of Pennsylvania’s Abramson Cancer Center in Philadelphia.

Early detection and improved treatment means more and more people are surviving cancer: there are some 12 million alive in the US today, writes the panel, explaining that this growing population faces unique health challenges posed by cancer recurrence, risk of other diseases, and side effects of their cancer and/or treatment.

Until recently, doctors advised cancer patients to rest and avoid physical activity: but an emerging body of evidence now challenges this view, so the panel reviewed the published evidence and gave recommendations.

They concluded that exercise training is safe during and after cancer treatment and improves physical functioning, quality of life and cancer-related fatigue.

And although they said it’s not yet clear what effect exercise has on survival and disease outcomes, the benefits to physical functioning and quality of life are so great that they recommend cancer survivors and patients with existing disease or undergoing difficult treatment “avoid inactivity” and follow the 2008 Physical Activity Guidelines for Americans, adapted to their particular situation, for example to take into account increased risk of bone fracture or cardiac side effects.

Schmitz told the press that:

“Our hope is that there will be more conversations about the need for formalized exercise programs for patients during and right after treatment — programs that will be the cancer equivalent to cardiac rehab.”

Schmitz said for a number of cancers, the benefits of exercise are well documented, particularly in reducing fatigue and improving physical functioning, both of which affect quality of life.

Co-author Dr Kerry Courneya from the University of Alberta, who has led a number of clinical trials examining how physical activity may or may not benefit cancer patients, said the strongest evidence is for people who have completed treatment, but because of differences in study designs they couldn’t compare evidence involving patients undergoing active treatment with patients who had finished their treatment.

During an education session at the annual American Society of Clinical Oncology (ASCO) meeting in June, he said:

“We’re finding that patients can do a lot more than we originally thought they could do, even when they’re on chemotherapy or radiation therapy.”

They found that even a small amount of exercise like regular brief walks showed gains compared to doing nothing.

The new guidelines point out that patients with different cancers have different treatments and they and their fitness adviser should take this into account when designing fitness programs.

For example, trainers instructing prostate cancer patients whose treatment included androgen deprivation should be aware of increased fracture risk. Another example is a woman who has undergone surgery to remove a breast cancer tumor may have a very weak shoulder and her fitness program should probably include exercises to stabilize and strengthen the surrounding muscle.

For some patients, there will be days when they are just to sick to exercise, in which case they should just decrease activity for a while, or wait a few days and then start again, said the panel.

But the guidelines only include specific recommendations, such as objectives and goals for a prescription for exercise (including potential contraindications), for patients with prostate, breast, colon, gynecologic, and hematologic cancers. This is because the panel felt there was not enough evidence to give detailed recommendations for patients with other cancers.

The guidelines also include the important need to improve body image. Many cancer patients have to have surgery or treatment that alters their appearance. This can result in loss of confidence, including feelings that they are no longer sexually attractive, said Schmitz.

However, she said there is good evidence that “physical activity can improve body image, and that may be one mechanism through which exercise can improve quality of life”.

Another important goal of exercise recommended in the guidelines is to improve body composition, which can change as a result of treatment, depending on the type of cancer. For example gastrointestinal and head and neck cancers can result in loss of weight and loss of muscle mass to the extent that patients can’t even get out a chair. For such patients, programs that help them build lean muscle would be really helpful.

However, almost the opposite problem occurs with breast cancer, for which there is the most abundant evidence, said the panel. For patients and survivors of breast cancer, the treatment they receive can often cause them to gain a lot of weight, and for them, exercise goals should focus on “controlling body weight, losing fat and getting back to a healthy BMI”, said Schmitz.

Although the evidence is not conclusive (Courneya described the emerging data as “exciting” but “still experimental”), the guidelines mention the possibility that for breast and colorectal cancer survivors, exercise after treatment could also reduce the likelihood of cancer recurrence and increase overall survival.

The guidelines also emphasize the importance of addressing a number of preparation issues before going ahead and implementing exercise programs for cancer patients and survivors. For example there is a need to educate oncologists, cancer specialists and patients about the benefits and the dos and don’ts of exercise during and after cancer treatment, there is a need to ensure there is appropriate insurance cover, and to increase the number of fitness professionals who understand the needs and concerns of cancer patients and survivors.

Marilyn McAllister, a trainer from Boise, Idaho, works with breast cancer survivors, privately and at a local hospital. She said while she has seen a lot of progress on the issues, a lot more needs to be done. For example, doctors don’t have time to talk to their patients about exercise because they are swamped with dealing with the details of the care issues, and patients are often too overwhelmed with information, and just giving them another leaflet about the benefits of yoga or strength training just “isn’t very helpful”.

McAllister is a cancer-certified trainer who gained her certification through a program developed jointly by the ACSM and the American Cancer Society (ACS). Other organizations also offer certification programs. For example, Schmitz helped ACSM develop a six-session cancer exercise trainer certification Webinar, and the Lance Armstrong Foundation has helped to train fitness staff at nationwide YMCA centers to work with cancer survivors.
McAllister said she found it deeply rewarding to work with cancer patients and survivors because while everyone benefits from exercise, the impact is more dramatic for cancer patients:

“It doesn’t take much training to produce big results in their lives,” she said.

Source: NCI.

Dispelling the notion that circulating levels of good and bad cholesterol in the blood are just the balance of dietary absorption and liver secretion and metabolism, US scientists who did tests on mice suggest that a neural circuit in the brain involving the hunger-signaling hormone ghrelin directly controls cholesterol metabolism by the liver.You can read about the discovery, led by Dr Matthias Tschöp, professor in the endocrinology division of the University of Cincinnati (UC), Ohio, in the 6 June online ahead of print issue of Nature Neuroscience.

In a statement, Tschöp told the media that:

“We have long thought that cholesterol is exclusively regulated through dietary absorption or synthesis and secretion by the liver.”

“Our study shows for the first time that cholesterol is also under direct ‘remote control’ by specific neurocircuitry in the central nervous system,” he added.

Tschöp and colleagues hope their finding will provide a target for new treatments for controlling cholesterol levels.Cholesterol, which circulates in the blood along with triglycerides and other lipids, is an essential structural component in cells in mammals and it also helps production of important substances like vitamins, digestive acids and hormones. However, too much cholesterol can result in atherosclerosis, a buildup of plaque in the arteries.

There are two types of cholesterol, the so-called “bad” or low-density lipoprotein (LDL) type, which is thought to be involved in plaque buildup and thus raises risk of metabolic and cardiovascular disorders, and the so-called “good” or high-density lipoprotein (HDL) type, which is thought to be beneficial.

Ghrelin is a hunger-signaling hormone that inhibits the melanocortin 4 receptor (MC4R) in the hypothalamus and plays a key role in regulating food intake and energy use.

Using lab mice, Tschöp and colleagues found that higher levels of ghrelin caused them to develop higher levels of blood-circulating cholesterol, which they attribute to a reduction in uptake by the liver.

When the researchers tested the effect of deleting or blocking MC4R in the central nervous system with chemicals, they found this also led to higher levels of circulating HDL cholesterol, and suggested MC4R was the key part of the “remote control” circuit.

“Inhibiting the brain’s melanocortin system by pharmacological, genetic or endocrine mechanisms increased circulating HDL cholesterol by reducing its uptake by the liver independent of food intake or body weight,” they wrote, concluding that:

“Our data suggest that a neural circuit in the brain is directly involved in the control of cholesterol metabolism by the liver.”

Tschöp said they were also “stunned to see that by switching MC4R off in the brain, we could even make injected cholesterol remain in the blood much longer”.

There are differences in the composition of mouse and human cholesterol, so more research is needed to verify if this effect also occurs in humans, cautioned the researchers, but they said nevertheless, these findings add to a growing pile of evidence that the central nervous system is far more involved in the control of essential metabolic processes than we once thought.

The National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases funded the study.

Source: University of Cincinnati.

Scientists at the Medical Research Council (MRC), UK have identified the structure of the critical enzyme respiratory complex I, solving an important part of the puzzle of how our cells get their energy from food. This discovery will result in new avenues of research into future potential treatments for neuromuscular and neurodegenerative diseases, such as Parkinson’s. An image of this L-shaped enzyme features on the cover of today’s edition of the journal Nature.Respiratory complex I is the first in a set of molecular ‘machines’ in mitochondria that transform energy in food into a form that can be utilized by cells. Mitochondria are the ‘power stations’ inside our cells.

As the first stage for cellular energy production, this enzyme is critical for the continued existence of the majority of cells in our bodies. However, it also creates chemical by-products, such as H2O2 (hydrogen peroxide), a strongly oxidizing liquid which can damage the DNA within the mitochondria. This damage builds up during a human’s life and probably contributes to ageing and to neurodegenerative diseases, such as Parkinson’s.By better understanding exactly how this enzyme works within cells, scientists will be able to identify when and where significant damage is likely to happen, hopefully resulting in new treatment options.

Dr Sazanov and team at the MRC (Medical Research Council) Mitochondrial Biology Unit had previously established the detailed structure of half of this enzyme with its distinctive L-shape. However, it took this most recent study for them to understand fully that its action appears to mimic that of a piston-driven steam engine, using an up and down motion to drive protons or ‘fuel’ across the mitochondrial membrane barrier.

Lead author, Dr Leonid Sazanov said:

“Determining the structure of ‘respiratory complex I’ will help us to better understand how the enzyme works at a fundamental level. Until now this has been a real mystery to researchers in the field, including those working towards limiting the damage to mitochondrial DNA in our cells and curbing the vicious effects of neurodegenerative diseases. As a scientist, I admit that I also find it very satisfying that one of the most efficient and elegant processes in the body bears a striking resemblance to one of the great man-made inventions.

In a previous study, Professor Sir John Walked, Director of the MRC Mitochondrial Biology Unit, had determined that respiratory complex V, or ATP synthase, that carries out the final process in the biological energy production, is a rotary machine that resembles a turbine engine. Professor Walker was awarded the 1997 Nobel Prize in Chemistry for this work.

Copyright: Medical News Today

Researchers in the US found that brief vigorous exercise can reduce cellular aging by preventing the shortening of telomeres due to stress.You can read about the University of California San Francisco (UCSF) study in a paper published online in the open access journal PLoS ONE on 26 May.
Co-lead investigator, Dr Elissa Epel, an associate professor in the UCSF Department of Psychiatry, said in a statement that:

“Telomere length is increasingly considered a biological marker of the accumulated wear and tear of living, integrating genetic influences, lifestyle behaviors, and stress.”

“Even a moderate amount of vigorous exercise appears to provide a critical amount of protection for the telomeres,” said Epel.

Telomeres are protective strips of DNA that cap the ends of chromosomes and stop them unravelling, not unlike the plastic sheaths on the ends of shoelaces.They were discovered by a group of 2009 Nobel Laureates that included Dr Elizabeth Blackburn, a co-author of the current paper.There is also growing evidence that short telomeres are linked to several health problems, including diabetes and coronary heart disease, as well as early death.

The researchers built on previous UCSF-led studies that found psychological stress causes overall wear and tear in the body at a deep level in cells by promoting cell aging through shortening telomere length. However, as Blackburn noted:

“We are at the tip of the iceberg in our understanding of which lifestyle factors affect telomere maintenance, and how.”

But, with this new study, it appears some of the iceberg is revealed, in that Epel, Blackburn and colleagues found that brief exercise, a modifiable lifestyle factor, buffers the telomere-shortening effect of stress.They discovered that even as little as 42 minutes of vigorous exercise over a 3-day period, similar to levels recommended by federal health authorities in the US, seems to protect individuals from the effects of stress by reducing its effect on telomere length.The US Centers for Disease Control and Prevention (CDC) recommends that adults undertake 75 minutes of vigorous, or 150 minutes of moderate activity, plus weight-bearing exercise, every week. For children and adolescents they recommend 90 minutes a day.For the study Epel, Blackburn and colleagues recruited 62 post-menopausal women, many of whom were caring for spouses or parents with dementia.The women reported at the end of each day how many minutes of vigorous activity they had engaged in. Vigorous activity was defined as “increased heart rate and/or sweating”.

In a separate assessment, the participants also reported their perceptions of life stress during the previous month. They also gave blood samples so the researchers could measure the telomere length of their immune cells.
The results confirmed earlier findings from research on premenopausal women that found psychological stress promoted immune cell aging through shortening of telomeres.

But when they analysed the results for the highly stressed women in terms of sedentary and inactive participants (the active participants included all those who met or exceeded the federally recommended 75 minutes of vigorous exercise a week), they found only the sedentary high stress participants had shorter telomeres.

The active, high stress participants did not have shorter telomeres. In other words, it appears that high stress predicted shorter telomeres in the sedentary but not the active group.The researchers suggested that for this group of older women, the CDC recommended level of vigorous exercise is enough to buffer the effect that psychological stress has on telomere length.But they said these results now need to be confirmed with larger groups.

Lead author Dr Eli Puterman, a psychologist in the UCSF Department of Psychiatry, said:

“At this point, we have replicated previous findings showing a link between life stress and the dynamics of how cells age.”

“Yet we have extended those findings to show that, in fact, there are things we can do about it. If we maintain the levels of physical activity recommended, at least those put forth by the CDC, we can prevent the unyielding damage that psychological stress may have on our body.”

Puterman also said they found the participants who reported more stress were also the ones who were less likely to exercise, which may be discouraging, but it offers an opportunity to find out why more vulnerable, stressed people don’t exercise much and find ways to encourage them to do so.

The researchers are now planning a study where participants get to know their own telomere length to see whether this motivates them to change their habits and do more exercise, reduce stress and eat less processed red meat, lifestyle factors that have been linked to telomere length.

Source: University of California San Francisco.

What is the best way to tackle the obesity crisis? There appears to be some disagreement among experts in the British Medical Journal (BMJ) today. While Professor Louise Baur and team from the Children’s Hospital at Westmead and the University of Sydney in Australia acknowledge that “physical inactivity is a major contributor to the global burden of disease,”  they say that it would be wrong to solely focus on this and disregard the problem of obesity.

Physical inactivity is just one marker, Baur and colleagues argue. They say there is substantial evidence that unhealthy diets low in fiber and high in sugar and large portion sizes are also responsible for obesity and the diseases linked to it.

However, Dr Richard Weiler, a specialist registrar in sport and exercise medicine at Imperial College Healthcare NHS Trust (UK) and general practitioner, and colleagues believe that inadequate cardio-respiratory fitness causes disease more than excess body fat, waist size and body mass index.Weiler and colleagues stress that..

physical inactivity is one of the greatest health threats facing developed nations today
..and they are concerned that 95% of the populations in the UK and the USA do not meet the recommended guidelines of doing 30 minutes moderate to vigorous exercise on at least 5 days a week or equivalent.

They say this is disturbing, given that physical inactivity rather than just obesity is an actual cause for many illnesses including obesity, heart disease, diabetes type 2, mental health problems, high blood pressure and dementia.

They argue that spending enormous amounts on obesity is not right the way to go. Weight loss drugs and surgery are hazardous and the long-term benefits are imperfect and they certainly do not have the associated health benefits associated with physical activity. They conclude that it is time for health policy and healthcare professionals to concentrate on tackling physical inactivity, a “chronic disease that has an adult population prevalence of 95%.”

Professor Baur, on the other hand, believes that..

on its own, improving physical activity will have little impact on reducing overall levels of already established obesity. She argues that obese individuals need access to top quality treatment provided by well-trained health care professionals to deal with their weight and any health problems linked to overweight.

In conclusion, Professor Baur and colleagues are in favor of attacking obesity with a range of strategies, such as improving lifestyle, diets, and increasing physical activity. They say urban planning should be designed to encourage people to use their cars less and cycle more, while public transport should be made more accessible and affordable.

Written by Christian Nordqvist
Copyright: Medical News Today

There are a limited number of good-quality studies on food allergies, with inadequate uniform criteria for making a diagnosis and establishing prevalence and effective treatment, says an article published in the Journal of the American Medical Association (JAMA), May 12th issue.

Family eco¬nomics, social interactions, school and work attendance and health-related quality of life can be severely undermined by food allergies.The authors of the article write “However, currently licensed treatments target only the symp¬toms of reactions and anaphylaxis [severe allergic reaction], not the allergies themselves.”

Background information on the article claims there is no clear agreement regarding the prevalence or most effective diagnostic and management approaches to food allergies.Jennifer J. Schneider Chafen, M.D., M.S., of the VA Palo Alto Healthcare System, Palo Alto, and Stanford University School of Medicine, Stanford, Calif., and team examined the available evi¬dence on the prevalence, diagnosis, man¬agement, and prevention of food aller¬gies. They identified 72 studies that met criteria. The studies had information on food allergies to cow’s milk, hen’s egg, pea¬nut, tree nut, fish, and shellfish – accounting for over 50% of all food allergies.

The researchers found that:

* Although elimination diets are the basis of therapy, they identified only 1 randomized controlled trial (RCT) of an elimination diet. “Many authorities would consider RCTs of elimination diets for serious life-threatening food allergy reactions unnecessary and unethical; however, it should be recognized that such studies are generally lacking for other potential food allergic conditions ..”
* Among high-risk babies, hydrolyzed formula may prevent against cow’s milk allergy, but standardized definitions of high risk and hydrolyzed formula do not exist. Probiotics combined with breastfeeding, hypoallergenic formula, or both may help stem food allergy, but their independent effects remain unclear.
* Food allergies affect over 1% or 2% but less than 10% of the American population. We are not even sure whether the prevalence of food allergies is rising.
* Food chal¬lenges, skin prick testing, and serum food-specific immunoglobulin E all have a role to play in making the diagnosis but no one test has suffi¬cient ease of use or sensitivity or speci¬ficity to be recommended over the other tests. Many other proposed diag¬nostic tests are of uncertain value due to lack of evidence.
* Immunotherapy, although currently not a licensed method for the treatment of food allergy, may be effec¬tive in generating desensitization, but whether this treatment can also gener¬ate long-term tolerance remains to be determined. The safety of immunotherapy is likely to vary with the food al-lergen and the route of therapy administration and, to date, has not been adequately studied.

The authors write “This systematic review of food aller¬gies found that the evidence on the prevalence, diagnosis, management, and prevention of food allergies is vo¬luminous, diffuse, and critically lim¬ited by the lack of uniformity for the diagnosis of a food allergy, severely lim¬iting conclusions about best practices for management and prevention.”

Source : Medical News Today

A new analysis of the medical costs of treating cancer in the US shows they have nearly doubled in the last 20 years; they also reveal a shift away from inpatient to outpatient care, and a rise in the proportion shouldered by private health insurance and Medicaid.You can read about the study, led by Dr Florence Tangka, a health economist at the Centers for Disease Control and Prevention (CDC), in this week’s early online issue of the American Cancer Society journal CANCER.

Tangka and colleagues from the CDC, Emory University, and RTI International hope their findings will help policy makers and budget holders prioritize spending on cancer treatment and prevention.

For their study they analyzed data from two nationally representative telephone surveys: the National Medical Care Expenditure Survey done once in 1987, and 2001 to 2005 data from its successor, the Medical Expenditures Panel Survey.

They found that:

* In 1987, the total medical cost of cancer in the US was $24.7 billion (in 2007 dollars).

* The largest share was borne by private insurance (42 per cent), followed by Medicare (33 per cent).

* Out of pocket expenses accounted for 17 per cent, other public sources 7 per cent, and Medicaid 1 per cent.

* Between 1987 and the 2001-2005 period, the total medical cost of cancer in the US went up to $48.1 billion.

* This increase was due to new cases among an aging population and increased prevalence of cancer.

* In 2001-2005, the largest share of the cost was borne by private insurance (50 per cent), followed by Medicare (34 per cent).

* Out of pocket expenses accounted for 8 per cent, other public sources 5 per cent, and Medicaid 3 per cent.

* The proportion of total cancer medical costs incurred after inpatient admission fell from 64.4 per cent in 1987 to 27.5 per cent in 2001-2005.

* This was accompanied by an increase in cancer-related outpatient costs.

In the US, Medicaid is a means tested health insurance program for individuals and families with low incomes and resources, and Medicare provides health insurance for people aged 65 and over, or who meet other special criteria (some beneficiaries can qualify for both).The researchers cautioned that their figures don’t reflect areas where costs could have been even greater, for instance people in long term care facilities, and people with advanced disease.

Tangka told the media these findings should help us better understand who pays for what in cancer prevention and treatment and how health reform and changes to financing and delivering health care affects the balance.She and her colleagues also noted that further research was needed to find out how these changes might affect costs and quality of cancer care in the US.

The findings appear to have come as a surprise to some experts, who would have expected such a study to find cost of drugs rather than rise in patient numbers to be the main reason for driving up the cost of cancer care.Another surprise finding was that as a proportion of the total cost of medical care in the US, cancer care has remained at around 5 per cent for the last 20 years.

While not disputing the findings, Dr Len Lichtenfeld of the American Cancer Society told ABC News he was “a bit surprised” by them: he would have expected a rise in the cancer care share of the total US medical cost of healthcare.

Reflecting on the value for money aspect of the increased cost of cancer care, Kenneth Thorpe, a health policy researcher at Emory University, said the increased spending represents money better spent because we now have better and more advanced treatments that are helping to keep more people alive:

“It seems like we’re buying increases in survival,” said Thorpe, according to an ABC News report.

“Cancer treatment cost in the United States: has the burden shifted over time?”
Florence K. Tangka, Justin G. Trogdon, Lisa C. Richardson, David Howard, Susan A. Sabatino, and Eric A. Finkelstein.
CANCER, Published Online: May 10, 2010.
DOI:10.1002/cncr.25150

Source: American Cancer Society, ABC News.

Researchers from France and the UK who reviewed the scientific literature found that drinking alcohol during pregnancy was linked to a significantly higher risk of children developing a rare form of leukemia called acute myeloid leukemia (AML).You can read about the study, led by Dr Paule Latino-Martel, research director at the Research Center for Human Nutrition in France, in the online May issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Leukemia is the most common cancer in children, and although we don’t know much about its causes, many scientists believe it results from an interaction between genes and environment, and drinking alcohol while pregnant has been raised as a possible candidate for the latter.For the study, Latino-Martel conducted a systematic review and meta-analysis of published studies to find all the already established links between maternal alcohol consumption during pregnancy and childhood leukemia. A meta-analysis is a way of pooling and re-analyzing data from several studies as if they had come from one large one.

They found 21 case-control studies where they could analyze links between diagnosis of leukemia in children born to mothers who answered yes or no to a question about alcohol consumption during pregnancy.They also looked at other factors such as type of leukemia, child’s age at diagnosis, type of alcoholic beverage and which trimester of pregnancy the mother drank alcohol, if she did.

The results showed:

* A statistically significant link between maternal alcohol drinking during pregnancy (yes versus no) and diagnosis of AML in the children (odds ratio OR 1.56 with 95 per cent confidence interval CI ranging from 1.13 to 2.15).

* No statistically significant link with acute lymphoblastic leukemia (OR 1.10 and 95% CI 0.93-1.29).

* For AML, drinking an extra drink a week was linked to a 24 per cent increase in risk (OR 1.24, 95% CI 0.94-1.64).

* Some heterogeneity between studies (this measures design consistency across studies: high heterogeneity means you should be careful about drawing overall conclusions from a pooled analysis).

* The link between AML and drinking alcohol during pregnancy was observed for diagnoses made at age 0 to 4 years (OR 2.68, 95% CI 1.85-3.89) in 5 studies with no heterogeneity.

The researchers concluded that:

“The results of case-control studies indicate that maternal alcohol consumption during pregnancy is associated with a significantly increased risk of AML in young children.”

According to figures published in 1998, the global annual rate of childhood leukemia varies from 20 to 60 cases per million, with more affluent countries generally having higher rates than less developed countries.

Dr Julie Ross, director of the division of pediatric epidemiology and clinical research at the University of Minnesota, was not involved with the study, but is a member of the editorial board of the journal that published it.

She said in a statement that there are around 700 childhood cases of AML a year in the US:

“It’s quite rare, so we want to be careful about worrying parents too much,” she urged.

However, she agreed that the findings strengthen the case for recommending women abstain from alcohol during pregnancy.

Latino-Martel said even though the current recommendation is that women should not drink alcohol when pregnant:

“… alcohol consumption during pregnancy is 12 percent in the United States, 30 percent in Sweden, 52 percent in France, 59 percent in Australia and 60 percent in Russia.”

“Maternal Alcohol Consumption during Pregnancy and Risk of Childhood Leukemia: Systematic Review and Meta- analysis.”
Paule Latino-Martel, Doris S.M. Chan, Nathalie Druesne-Pecollo, Emilie Barrandon, Serge Hercberg, and Teresa Norat.
Cancer Epidemiol Biomarkers Prev, May 2010 19:1238-1260.
DOI:10.1158/1055-9965.EPI-09-1110

Source: AACR, Children with Leukemia (UK).

When your mind wanders, you’re not paying attention to what’s going in front of you. A new study suggests that it’s not just the mind, it’s the body, too; when subjects’ minds wandered, they blinked more, setting up a tiny physical barrier between themselves and the outside world.

Cognitive neuroscientist Daniel Smilek, of the University of Waterloo, studies how people pay attention – and don’t. For this study, he was inspired by brain research that shows, when the mind wanders, the parts of the brain that process external goings-on are less active. “And we thought, ok, if that’s the case, maybe we’d see that the body would start to do things to prevent the brain from receiving external information,” Smilek says. “The simplest thing that might happen is you might close your eyes more.” So, Smilek and his colleagues, Jonathan S.A. Carriere and J. Allan Cheyne, also of the University of Waterloo, set out to look at how often people blink when their mind wanders.

Fifteen volunteers read a passage from a book on a computer. While they read, a sensor tracked their eye movements, including blinks and what word they were looking at. At random intervals, the computer beeped and the subjects reported whether they’d been paying attention to what they were reading or whether their minds were wandering – which included thinking about earlier parts of the text.

The participants blinked more when their minds were wandering than when they were on task, the team reports in Psychological Science, a journal of the Association for Psychological Science. “What we suggest is that when you start to mind-wander, you start to gate the information even at the sensory endings – you basically close your eyelid so there’s less information coming into the brain,” says Smilek.

This is part of a shift in how scientists are thinking about the mind, he says. Psychologists are realizing that “you can’t think about these mental processes, like attention, separately from the fact that the individual’s brain is in a body, and the body’s acting in the world.” The mind doesn’t ignore the world all by itself; the eyelids help.

Source: Association for Psychological Science

Many cancers detected by screening tests are not destined to cause symptoms or death and therefore represent a phenomenon known as overdiagnosis. And because overdiagnosis leads to unnecessary treatment and other harms, it is important to develop clinical and research strategies to quantify, recognize, and manage it, according to a review published online in the Journal of the National Cancer Institute.

H. Gilbert Welch, M.D. and William Black, M.D., of the Dept. of Veterans Affairs Medical Center, White River Junction, Vt. and the Dartmouth-Hitchcock Medical Center used data from large randomized screening trials to estimate the extent of overdiagnosis. They found that about 25% of breast cancers detected on mammograms and about 60% of prostate cancers detected with prostate-specific antigen (PSA) tests could represent overdiagnosis. In a lung cancer screening trial of chest x-rays and sputum tests, they estimate that 50% of the cancers detected represented overdiagnosis. They argue that this estimate will only increase with spiral CT scanning, which, in one observational study, found almost as many lung cancers in non-smokers as smokers.

The authors also point to cancer incidence and mortality statistics as evidence of overdiagnosis in some cancers. For five cancers – thyroid, prostate, kidney and breast cancer, and melanoma – data from the past 30 years show an increasing number of new cases but not an increase in deaths. In each of these cancers, an increase in screening or imaging tests has been associated with an increasing rate of new diagnoses.

In addition to screening, other procedures, such as diagnostic imaging, may contribute to overdiagnosis. CT colonography (virtual colonoscopy) for instance, often detects abnormalities outside the colon that can lead to more tests and possibly overdiagnosis.

The authors suggest several strategies to address the problem. One is to educate patients about the risks and benefits involved with early detection.

“Whereas early detection may well help some, it undoubtedly hurts others,” they write. “Often the decision about whether or not to pursue early cancer detection involves a delicate balance between benefits and harms…different individuals, even in the same situation, might reasonably make different choices.”

Another strategy to reduce overdiagnosis is to raise the threshold at which a screening test result is labeled ‘abnormal’, or at which further steps are taken. For instance, investigators could test whether it was better to ignore small abnormalities detected on imaging tests, as is now the practice with lung nodules detected by CTscans.

“It is possible that new insights from genomics will ultimately allow us to more accurately predict tumor behavior at the individual level,” the authors write. “However the field has not advanced to that point yet. We must explore other clinical strategies.”

In an accompanying editorial, Laura Esserman, M.D., University of California, San Francisco and Ian Thompson, University of Texas Health Science Center at San Antonio, stress the critical importance of addressing the problem of overdiagnosis.

“What we need now in the field of cancer is the coming together of physicians and scientists of all disciplines to reduce the burden of cancer death AND cancer diagnosis,” they write. “We must advocate for and demand innovation in diagnosis and management, fueled by science, harnessing modeling, molecular, and immunology tools to address this problem.”

Source:
Journal of the National Cancer Institute

A new decades-long study has just launched to investigate whether there is a link between the use of mobile phones and long-term health problems such as cancer.The cohort study on mobile communications (COSMOS) forms part of the Mobile Telecommunications and Health Research (MTHR) Programme. The international study will run for 20-30 years and will follow the health of at least 250,000 participants aged 18-69 in five European countries. The UK arm of COSMOS is being led by a research team from Imperial College London.

There are currently over six billion mobile phone devices in use worldwide, with over 70 million in use in the UK, which has a population of 61 million people.Studies of short term use of mobile phones and health have been reassuring, other than well known associations with risk of motor accidents. However, there are still some uncertainties about the health effects of mobile phone use, since some diseases take many years to develop and so far few people have been using mobile phones for that period of time.

Dr Mireille Toledano, co-Principal Investigator of the study from the School of Public Health at Imperial College London, said: “For the benefit of current users and for future generations, it is important for us to carry out long term health monitoring of a large group of mobile phone users so that we can identify if there are any possible health effects from this new and widespread technology that has become so central to our everyday lives.”Professor Paul Elliott, Principal Investigator of the study from the School of Public Health at Imperial College London, said: “Scientists have been looking at the effects of mobile phones on health for several years and so far, reviews of the research have been reassuring with respect to mobile phone use and health problems in the short term. However, as mobile phones have only been in widespread use for a relatively short time, we haven’t been able to carry out long-term studies until now.

“COSMOS aims to fill in important gaps in our knowledge of mobile phones and health. By looking at large numbers of people across Europe over a long period of time, we should be able to build up a valuable picture of whether or not there is any link between mobile phone use and health problems over the long term,” added Professor Elliott.

Through four major mobile phone operators, the COSMOS project team from Imperial College London is inviting 2.4 million mobile phone users in the UK to take part in the study.

“We can only do this study and find out whether mobile phones are affecting our health in the long term with the help of the public willing to take part. Through contributing a small amount of time to this study, participants will make a big difference to our understanding of mobile phones and health. Anyone who wants to find out more and get in touch with us can visit our website at http://www.ukcosmos.org,” said Dr Toledano.

Participants who agree to take part in the study will complete an on-line questionnaire about their mobile phone use, health and lifestyle. The researchers will monitor participants’ mobile phone use and any health problems they might develop, e.g., cancers and neurological diseases such as Alzheimer’s disease, for at least the next 20 years. They will also analyse whether any changes in the frequency of symptoms, such as headaches and sleep disorders, are related to mobile phone usage.

“Over the past decade, mobile phones have become a normal part of everyday life for the majority of people in Britain. The COSMOS study is the largest research study worldwide investigating mobile phone use and health and is a very important step towards finding out whether there are health implications of using a mobile phone over a long period of time,” said Dr Toledano.

Professor Lawrie Challis from the MTHR Programme Management Committee said “We still cannot rule out the possibility that mobile phone use causes cancer. The balance of present evidence does not suggest it does but we need to be sure. The best way of doing this is through a large cohort study such as COSMOS and I am very pleased that the UK is to play an important part in this international endeavour”

The study follows on from successful pilot studies carried out between 2004-2008 during the first phase of the MTHR Programme.

Source:
Imperial College London

Copyright: Medical News Today

The US Food and Drug Administration (FDA) should regulate salt as a food additive and gradually tighten the limit on the amount that manufacturers, restaurants and food service providers can add to processed foods and prepared meals, said experts in a new report this week. They base the recommendation on a review of past efforts to reduce sodium intake in the US, which has not changed much in the last 40 years, despite it being a top national health priority.You can read the report, titled Strategies to Reduce Sodium Intake in the United States, online as a pre-publicaton edition. It comes from the Institute of Medicine (IOM), an independent body established under the charter of the National Academy of Sciences to advise health professionals, policymakers, the private sector, and the public. This particular report was requested by Congress and supported by a number of federal health agencies.

Since the 1970s, reducing sodium intake has been, and still is, an important public health goal for the US, yet despite an array of public health interventions, national standards and guidelines, Americans still consume more sodium than is good for their health, putting individuals at higher risk for blood pressure and related diseases, write the authors.Also, American eating habits have changed significantly in the past few decades. Where once, much of the sodium consumed came from salt added during home cooking of meals prepared from fresh ingredients or at the table via the salt shaker, for the vast majority of Americans today, dietary sodium comes from the salt that manufacturers, restaurants and food service companies add to processed foods and prepared meals.

Since salt has been added to food for centuries, it is generally recognized as safe, so currently the FDA does not regulate it as a substance that has the potential to harm public health: to do so would be a completely new thing for the FDA.But the IOM authors argue that there is enough evidence of the harm it can do when intake goes over a certain limit: studies have linked high sodium intake to high blood pressure, heart attacks, strokes, kidney disease, and other serious and fatal conditions.

They recommend that the FDA gathers and reviews the research evidence and decide what the limits should be on the use of salt as an additive to processed foods and prepared meals.Americans have gradually become accustomed to consuming more salt every day, as the amount of salt in the nation’s food supply has gone up over the years. However, research shows that people can get used to eating food with less salt, if it is done gradually: people’s tastes can be reset to less salty flavors, wrote the authors.

Thus they recommend that rather than jump straight to a low limit of added salt, the FDA should do it step by step, gradually bringing the limit down so that people get used to the flavor of processed and prepared foods with less salt in it.The goal is not to ban salt altogether, wrote the authors, but phase it down to below the levels associated with risk of high blood pressure and related diseases.

First author Jane E Henney, professor of medicine at the University of Cincinnati College of Medicine, and chair of the committee that did the research and wrote the IOM report, told the press that the report outlines ways we can all effectively reduce our sodium intake to healthy levels:

“For 40 years we have known about the relationship between sodium and the development of hypertension and other life threatening diseases, but we have had virtually no success in cutting back the salt in our diets.”

She said the best way for us to reduce our salt intake is to:

“Provide companies the level playing field they need so they are able to work across the board to reduce salt in the food supply.”

“Lowering sodium by the food industry in a stepwise, monitored fashion will minimize changes in flavor and still provide adequate amounts of this essential nutrient that are compatible with good health,” she explained.

The average American consumes 3,400 grams of sodium a day, which is roughly that contained in 1.5 teaspoons of salt. The 2005 Dietary Guidelines for Americans recommends a maximum intake of 2,300 grams for adults, or about 1 teaspoon of salt. Above this level, and there is a higher risk of developing health problems.

The IOM suggests that 1,500 milligrams per day is adequate for adults, and people over 50 need even less.

The authors also recommend that the percentage of Daily Value for sodium figure shown on food packaging, which tells the consumer how much of their recommended daily intake of sodium is in the product, should change to express the amount as a percentage of the adequate level, rather than the maximum level, as the latter mistakenly implies that this is a recommended intake. They also point out that the current figure is based on an earlier maximum limit of 2,400 grams.

“Strategies to Reduce Sodium Intake in the United States.”
Jane E. Henney, Christine L. Taylor, and Caitlin S. Boon.
The National Academies Press, prepub PDFs, and online versions published 20 April 2010.

Sources: IOM.

US researchers found that people who consume higher amounts of added sugar, such as in processed foods and beverages, are also likely to have higher heart disease risk factors.You can read about the study by researchers at Emory University School of Medicine and the US Centers for Disease Control and Prevention (CDC), both in Atlanta, Georgia, online in the 21 April issue of JAMA, Journal of the American Medical Association.A statement from Emory University describes the study as the first of its kind to examine the link between the consumption of added sugars and lipid measures, such as HDL-C, triglycerides and LDL-C.

(HDL-C stands for high-density lipoprotein cholesterol, and is sometimes referred to as “good” cholesterol, and LDL-C stands for low-density lipoprotein cholesterol, the so-called “bad” cholesterol.)

Co-author Dr Miriam Vos, who is assistant professor of pediatrics at Emory School of Medicine, told the press that:

“Just like eating a high-fat diet can increase your levels of triglycerides and high cholesterol, eating sugar can also affect those same lipids.”

In their background information the authors wrote that data from the mid-1990s shows that Americans consume nearly 16 per cent of their daily energy from added sugars, the most common of which are refined beet or cane sugar (sucrose) and high-fructose corn syrup.They explained that guidelines on healthy eating use the term “added sugar” to help consumers identify foods that have lots of calories and few nutritients, and defined it as “caloric sweeteners used by the food industry and consumers as ingredients in processed or prepared foods to increase the desirability of these foods”.However, there appears to be little consensus on what is a healthy limit, and also, while increased carbohydrate consumption has been linked to blood fat profiles that raise cardiovascular risk, nobody has yet looked at how much of this could be from added sugars.

For the study, Vos and colleagues looked for links between added sugar consumption, blood fat levels and cardiovascular risk factors in data on 6,113 adults who took part in the 1999 to 2006 National Health and Nutrition Examination Survey (NHANES).They did not look at natural sugars found in fruit and fruit juices, only added sugars and caloric sweeteners.To aid statistical comparisons, the researchers put the participants into 5 groups according to the extent to which added sugar contributed to daily calories: under 5 per cent (reference group), 5 to under 10 per cent, 10 to under 17.5 per cent, 17.5 to under 25 per cent, and 25 per cent and over.They found that the groups that consumed the most added sugar were more likely to have higher cardiovascular disease risk, including higher levels of triglyceride and higher ratios of triglycerides to HDL-C.

More specifically the results showed that:

* An average of 15.8 per cent of consumed calories was from added sugars.

* The highest consuming group (25 per cent and over) consumed an average of 46 teaspoons of added sugars per day.

* The lowest consuming group (under 5 per cent, the reference group), consumed an average of only 3 teaspoons of added sugar per day.

* Among those consuming under 5 per cent, 5 to under 17.5 per cent, 17.5 to under 25 per cent, and 25 per cent and over, the adjusted mean HDL-C levels were 58.7, 57.5, 53.7, 51.0, and 47.7 mg/dL respectively (P < .001 for linear trend).

* For these same groups, the geometric mean triglyceride levels were 105, 102, 111, 113, and 114 mg/dL (P < .001 for linear trend).

* And for women, the LDL-C levels modified by sex were 116, 115, 118, 121, and 123 mg/dL (P = .047 for linear trend), while men showed no significant trends in LDL-C levels.

* Among those who consumed 10 per cent or more of calories from added sugar, the odds of low HDL-C levels were 50 to more than 300 per cent greater compared with those who limited it to under 5 per cent (the reference group).

Vos and colleagues concluded that:

“In this study, there was a statistically significant correlation between dietary added sugars and blood lipid levels among US adults.”

Vos said for the sake of their long term health people should look at how much added sugar is in their diet and find ways to cut it down.

“Caloric Sweetener Consumption and Dyslipidemia Among US Adults.”
Jean A. Welsh; Andrea Sharma; Jerome L. Abramson; Viola Vaccarino; Cathleen Gillespie; Miriam B. Vos
JAMA, Vol. 303 No. 15, April 21, 2010

Source: Emory University.

Metformin, a mainstay of treatment for patients with type 2 diabetes, may soon play a role in lung cancer prevention if early laboratory research presented here at the AACR 101st Annual Meeting 2010 is confirmed in clinical trials.

Metformin decreases levels of insulin-like growth factor-1 (IGF-1) and circulating insulin, which is important in patients with type 2 diabetes. However, emerging research suggests metformin may inhibit tumor growth as well.

“This well tolerated, FDA-approved diabetes drug was able to prevent tobacco-carcinogen induced lung tumors,” said Phillip A. Dennis, M.D., Ph.D., senior investigator in the medical oncology branch of the National Cancer Institute.

For the current study, Dennis and colleagues treated mice with metformin for 13 weeks following exposure to a nicotine-derived nitrosamine (NNK), which is the most prevalent carcinogen in tobacco and a known promoter of lung tumorigenesis.

When given orally, metformin was well tolerated and reduced tumor burden by 40 percent to 50 percent. Dennis said levels of metformin reached in mice are readily achievable in humans.

Dennis and colleagues further evaluated the effects of metformin on a series of biomarkers for lung tumorigenesis and found that it inhibited mammalian target of rapamycin (mTOR), which promotes lung tumor growth, by decreasing levels of circulating insulin and IGF-1. This effect was even more profound when metformin was administered to mice by injection, which reduced lung tumor burden by 72 percent.

Source:  American Association for Cancer Research

US researchers writing in a leading journal concluded that a new form of pelleted tobacco product that in some cases looks like candy could poison children and lure young people into nicotine addiction.You can read about the study, by researchers from the Harvard School of Public Health (HSPH), the Food and Drug Administration (FDA), the Northern Ohio Poison Control Center and the Centers for Disease Control and Prevention (CDC), online in the 19 April ahead of print issue of Pediatrics.

Last year, RJ Reynolds, one the biggest tobacco companies in the US, started market testing a new pelleted product made with finely ground tobacco flavoured with mint or cinnamon that dissolves in the mouth like breath mints. The product, called Camel Orbs, contains 1 mg of nicotine per pellet, which is about the same as that contained in the average nicotine lozenge marketed to people trying to quit smoking.

However, according to a CNN news report, Orbs, and other products in the range, Camel Strips (0.6 mg nicotine per strip) and Sticks (3.1 mg nicotine per strip) appear to be a new trend in the tobacco industry to create smokeless nicotine products that people can use in places where it is no longer legal to smoke, like bars and restaurants.1 mg of nicotine is enough to make a small child feel nausea and vomit, said the researchers, who in their background information stressed that one of the biggest causes of poisoning that leads to calls to poison control centers throughout the US is babies and children swallowing tobacco products. The figures for 2007 show over 6,700 reported cases of tobacco-related poisoning among children aged 5 and under.

A poison control center in Portland, Oregon has already reported a case where a three-year old ingested an Orbs pellet. The center is in a region where the tobacco product is being test marketed.Lead author and director of the Tobacco Control Research Program at HSPH, Professor Gregory Connolly, told the media that the introduction of these new products could be disastrous for public health, particularly for infants and adolescents.Connolly said that while the product might be described as a “tobacco” product, to a four-year old child it looks like candy.

“Nicotine is a highly addictive drug and to make it look like a piece of candy is recklessly playing with the health of children,” said Connolly.

The researchers also noted that intentional use of smokeless tobacco products among adolescents went up 6 per cent per year from 2002 to 2006.

For the study the researchers worked out how much nicotine, based on median body weight, children would have to ingest to experience symptoms of poisoning:

* A one-year old child could get mild to moderate symptoms of poisoning from 8 to 14 Orbs, 14 Strips or 3 Sticks, while ingesting 10 to 17 Orbs, 17 Strips or 3 to 4 Sticks, could cause severe poisoning and death.

* A four-year old child could get mild to moderate symptoms of poisoning from 13 to 21 Orbs, 14 Strips or 4 Sticks, while ingesting 16 to 27 Orbs, 27 Strips or 5 Sticks, could cause severe poisoning and death.

The manufacturer argues that the packaging is child resistant, but the researchers said that adults could leave them lying around opened, and that this together, with their appealing candy-like appearance and flavoring, increases the chances that children will ingest them.

In an interview reported by CNN, Reynolds spokesman David Howard, said he didn’t think Camel Orbs looked “at all” like Tic Tac mints.

Howard stressed that the product was marketed to adults and came in child-resistant containers, and said it was unfair to criticize a product because of its flavoring, and pointed to smoking cessation aids like Nicogum. Besides, nearly every household has products that can poison children, such as cleaning products, medicines, health and beauty products, he said.But that is not the point, commented one expert, who said children will be influenced by the behavior of the adults they observe.

Dr Jonathan P Winickoff, a Harvard medical professor and chairman of the American Academy of Pediatrics Tobacco Consortium, told CNN that, the last time he checked, he didn’t see adults going around “drinking toilet bowl cleanser in front of their kids”.Winickoff also commented that accidental poisoning of young children was no the only cause for concern, intentional use by kids and teenagers was likely to be another public health problem from introduction of dissolvable nicotine products.

He said teenagers will look at the products and think they are harmless, and not realize they are exposing their brains to nicotine and priming themselves to become nicotine addicts.

“If teens ended up using smokeless product because they are attracted to candy flavors and they end up getting addicted to nicotine, the public health benefit of smokeless tobacco is neutralized,” said Winickoff, who was not involved in the study.

“Unintentional Childhood Poisonings Through Ingestion of Conventional and Novel Tobacco Products.”
Gregory N. Connolly, Patricia Richter, Alfred Aleguas Jr, Terry F. Pechacek, Stephen B. Stanfill, Hillel R. Alpert.
Pediatrics, online April 19, 2010.

Source: HSPH, CNN.