:::: Best Medical News ::::

Malaria drug potency is restored

2008-11-15T14:11:00.000-08:00

Scientists have found a way to breathe new life into an old anti-malarial drug which had been rendered almost useless. Chloroquine was hugely successful in combating the disease when launched in the ۱۹۵۰s - but the malaria parasite gradually became resistant.

Now Australian researchers have found combining the drug with another preparation, Primaquine, seems to restore its effect.

New Scientist magazine reports that new malaria drugs are needed badly.

The parasite which causes the disease - Plasmodium falciparum - has proved extraordinarily adept at evolving to combat many of the drugs currently on the market.

And those that are in use, known as artemisinin-based combination therapies, are expensive - and thus not readily available in the poorest countries where need is greatest.

Last week UNICEF, the United Nations Children’s Fund, warned that ۶ million people in Ethiopia, many of them children under five, were at risk of contracting malaria.

Toxic compound

Chloroquine - which is far cheaper than more modern malaria drugs - works by blocking the way the parasite breaks down human haemoglobin contained in red blood cells.

If the haem molecules remain in an uncrystallised form, they are toxic to the parasite, and kill it.

However, to be effective chloroquine must reach a high concentration in the digestive apparatus of the parasite.

Research by the Liverpool School of Hygiene and Tropical Medicine showed resistant forms of the parasite can effectively neutralise the drug by developing a mechanism that drains chloroquine away from the key area, preventing it from reaching the necessary concentration.

This means that while the drug may ease malaria symptoms, it will not cure the infection.

A team from La Trobe University in Melbourne tested the effect of combing chloroquine with primaquine, a drug normally used to treat a less severe form of malaria.

On its own, primaquine has no effect on P. falciparum, but it is structurally similar to chloroquine.

The La Trobe team believes that primaquine acts to block the pores on the surface of the parasite’s digestive apparatus - thus preventing chloroquine from leaking out.

Researcher Dr Leann Tilley said: “If you put chloroquine and primaquine together at the right concentration in the lab, it’s as effective on chloroquine-resistant parasites as chloroquine is on sensitive parasites.”

Dr Tilley, who presented her work to a meeting of the Australian Society for Microbiology in Canberra, plans to start field trials of the drug combination soon, perhaps in Indonesia.

Possible complication

Professor Ron Behrens, of the London School of Hygiene and Tropical Medicine, said primaquine was not suitable for all patients, as it could trigger the break down of red blood cells in people with an enzyme deficiency.

He said testing people for the deficiency before administering the drug combination could push costs up.

Professor Behrens said: “It is an interesting biochemical process that they have uncovered, but my anxiety is that primaquine is not an easy drug to use widely.

“However, it may be that now they have found a mechanism, they will be able to find other safer drugs to use in combination with chloroquine.”

Dr Tilley said cheap tests for the enzyme deficiency were available, but agreed they would add to the cost of treatment.

“Any trial which we set up to test the efficacy of the treatment will also need to assess the potential risk to the patients with this deficiency.”

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The WHO announces new standards for registration of all human medical research

2008-11-15T14:10:00.000-08:00

BRUSSELS/GENEVA

– The World Health Organization (WHO) is urging research institutions and companies to register all medical studies that test treatments on human beings, including the earliest studies, whether they involve patients or healthy volunteers. As part of the International Clinical Trials Registry Platform, a major initiative aimed at standardizing the way information on medical studies is made available to the public through a process called registration, WHO is also recommending that ۲۰ key details be disclosed at the time studies are begun.

The initiative seeks to respond to growing public demands for transparency regarding all studies applying interventions to human participants, known as clinical trials. Before making the recommendations announced today, the Registry Platform initiative consulted with all concerned stakeholders, including representatives from the pharmaceutical, biotechnology and device industries, patient and consumer groups, governments, medical journal editors, ethics committees, and academia over a period of nearly two years.

Registration of all clinical trials and full disclosure of key information at the time of registration are fundamental to ensuring transparency in medical research and fulfilling ethical responsibilities to patients and study participants,” said Dr Timothy Evans, Assistant Director-General of the World Health Organization.

Although registration is voluntary, there is a groundswell of policies aimed at spurring registration of all clinical trials. In July ۲۰۰۵, for example, the International Committee of Medical Journal Editors, a group representing ۱۱ prestigious medical journals, instituted a policy whereby a scientific paper on clinical trial results cannot be published unless the trial had been recorded in a publicly-accessible registry at its outset.

Some groups have raised concerns that these new requirements could jeopardize academic or commercial competitive advantage if they apply to preliminary trials of new interventions. Similar concerns have been voiced about the requirement to disclose certain items–such as the scientific title of the study, the name of the treatment being tested and the outcomes expected from the study–at the time of registration.

“Our aim is to make clinical research transparent and enhance public trust in science, but we are engaged in a fair and open process with all stakeholders. We look forward to continued dialogue about trial registration and results reporting as we move forward with the Registry Platform,” said Dr Ida Sim, Associate Director for Medical Informatics at the University of California, San Francisco and coordinator of the Registry Platform initiative.

The planned Registry Platform will not be a register itself, but rather will provide a set of standards for all registers. It has not only standardized what must be reported to register a trial but is creating a global trial identification system that will confer a unique reference number on every qualified trial.

Currently, there are several hundred registers of clinical trials around the world but little coordination among them. The Registry Platform seeks to bring participating registers together in a global network to provide a single point of access to the information stored in them.

Later this year, the WHO Registry Platform will launch a web-based search portal where scientists, patients, doctors and anyone else who is interested can search among participating registers for clinical trials taking place or completed throughout the world.

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Clone ‘would feel individuality’

2008-11-15T14:09:00.000-08:00

A cloned human would probably consider themselves to be an individual, a study suggests. Scientists drew their conclusions after interviewing identical twins about their experiences of sharing exactly the same genes with somebody else.

The team said the twins believed their genes played a limited role in shaping their identity.

The UK/Austrian research will shortly be published in the journal of Social Science and Medicine.

Co-author Dr Barbara Prainsack, from the University of Vienna, Austria, who worked with Professor Tim Spector, from the Twins Research Unit, St Thomas’ Hospital, London, said: “The birth of Dolly the sheep triggered many questions about what it would be like to be a clone.

“We don’t have clones we can interview - but we do have identical twins.”

Identical twins are created when a single egg, fertilised by a single sperm, splits into two separate, but genetically identical, embryos.

The researchers said because twins - like potential clones - share the same genes, they offer the only existing method of studying the feelings a clone might experience.

But they also emphasized twins would differ from clones because they are born at the same time, whereas clones would differ in age.

One of a pair?

The scientists carried out ۱۷ interviews of identical, non-identical and non-twin siblings.

The identical twins said being a twin did not compromise their individuality - although they pointed out that people often had preconceptions that they were one of a pair rather than individuals.

Those interviewed viewed being an identical twin as a blessing, and said they would not rather be a non-identical twin or a “singleton”.

They also said they believed their genes had no great bearing on their relationship with their twin and their identity.

The twins felt factors such as being brought up in the same environment, having spent a large part of their lives together, and being treated in a similar way by their parents were more important.

One interviewee said: “We spent ۲۰ years together, and so that was a close experience. And that hasn’t changed all of these years we’ve been apart. So I don’t feel that genetics made any difference.”

From these findings the scientists said they could assume a clone would probably not feel their individuality was compromised by sharing genes with someone else; that their relationship with their co-clone was a blessing; and their uniqueness was not a negative thing.

Dr Prainsack said: “According to the genetically identical people in our study, the problem would not be genetic sameness, but more the motives with which somebody would determine somebody else’s genome.

“The cloning debate would benefit from shifting away its focus from genetic sameness to looking more at social reasons for why the deliberate creation of human beings with a certain genetic make-up could hurt society.”

Professor Robin Lovell-Badge, a geneticist from the Medical Research Council’s National Institute for Medical Research, London, said: “Human reproductive cloning is not safe and should not be attempted with current knowledge.

“In my opinion, there are no strong reasons for even attempting it.

“But this interesting study and, although small, reveals how we should not have any prejudiced feelings about the idea of genetically identical individuals living amongst us.”

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Weight loss ‘can herald dementia’

2008-11-15T13:59:00.000-08:00

Weight loss can be a sign that a woman will develop dementia in the future, US researchers have discovered. In a study of over ۱,۰۰۰ people, women who later developed dementia had a drop in weight as early as a decade prior to the onset of memory loss.

The Mayo Clinic team do not think their finding will help doctors spot early dementia but say it could shed light on the brain mechanisms dementia affects.

They presented their work at an Alzheimer’s conference in Spain.

The study

The researchers identified ۵۶۰ people who were diagnosed with dementia between ۱۹۹۰ and ۱۹۹۴. They then found a group of people of similar age who did not have dementia.

They looked back at the weight of all of the patients over the preceding ۳۰ years.

Among the women in the study, those who later developed dementia started off at the same weight as those who did not develop dementia, but then their weight drifted downward by a few pounds ۱۰ years before the developed any dementia symptoms.

The weight of these women also went downward a few more pounds when the memory loss first manifested.

Lead researcher Dr David Knopman said: “The weight of those women who developed dementia was drifting downward many years before the onset of symptoms.

“This illustrates changes that occur before the memory loss and mental decline in dementia.

“We believe that the brain disease began to interfere somehow with maintenance of body weight, long before it affected memory and thinking.”

Disease processes

He said there were several possible explanations for how this might occur.

It might be that the disease processes that cause dementia also have an effect on initiative and therefore the women lose interest in eating.

Alternatively, women with imminent dementia might develop a duller sense of smell or taste.

“Or they might experience an earlier sense of satiety - feeling full.”

Dr Knopman said it was possible the weight loss could have something to do with hormonal changes around the time of menopause because they did not find the same trend among the men that they studied.

However, a study reported in the Archives of Neurology in January ۲۰۰۵ found men who later developed dementia experienced weight loss up to six years before diagnosis.

Preventing dementia

The UK authors of this study, Dr Robert Stewart and colleagues from the Institute of Psychiatry, London, said: “An important consideration arising from research in this area is the extent to which weight loss may be prevented or minimised in dementia.

“Poor nutrition and frailty frequently complicate later stages of dementia, causing falls, poor wound healing, and increased physical dependence.”

Past studies have suggested that dietary interventions may prevent weight loss in patients with Alzheimer’s disease and may delay cognitive decline and mortality.

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: “These findings need to be take further urgently as they may reveal how dementia develops and therefore provide routes to the new treatments we so desperately need.”

She added: “The difference in men and women suggested by this latest research suggests it could be linked to post-menopausal hormone changes.

“This is interesting as low oestrogen levels in women have been shown to increase the risk of dementia.”

Dr Susanne Sorensen, of the Alzheimer’s Society, said: “The observed weight loss is interesting as it could indicate the part of the brain responsible for weight loss is also one of the first to be damaged by the disease.

“Further research is now needed to identify what causes this weight loss

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US Senate debates stem cell bill

2008-11-15T13:58:00.000-08:00

The US Senate has begun a debate over a bill to increase the funding of embryonic stem cell research. If the bill passes as expected in voting on Tuesday afternoon, President George Bush has vowed to use his veto for the first time to block it.

Opinion polls suggest most Americans favour the research, which scientists hope could lead to treatments for a wide range of serious illnesses.

But Mr Bush has consistently opposed embryonic research on moral grounds.

The Senate will debate three separate stem cell bills over Monday and Tuesday, with voting on Tuesday.

The most controversial bill, the Stem Cell Research Enhancement Act, would scrap limits on federal funding imposed by Mr Bush in ۲۰۰۱.

It has already been passed by the House of Representatives.

Republicans at odds

In the years since Mr Bush’s ban was imposed, pressure for a loosening of restrictions has built.

Campaigners for such research include prominent Republicans such as Nancy Reagan, widow of former President Ronald Reagan, who died after a long battle with Alzheimer’s.

Senate Majority Leader Bill Frist backed Mr Bush in ۲۰۰۱ but now says the administration’s policy has proved “too restrictive”. He points out that the embryos proposed for use in stem cell research are left over from in-vitro fertilisation (IVF) treatments, and so would be thrown away anyway.

And opinion polls suggest almost two-thirds of Americans support the research.

But Mr Bush remains firmly against any change to the law, along with many other conservative Republicans.

‘Destroying life to save life’

“The use of taxpayers’ money to promote science which destroys life in order to save life - I’m against that, and therefore if the bill does that, I will veto it,” Mr Bush warned Congress recently.

Should Mr Bush veto the bill, Congress would have to vote by a two-thirds majority to override the veto.

That would require ۲۹۰ of the ۴۳۵ votes in the House of Representatives. It was ۵۰ votes short of that last year when it approved the stem cell bill last year. Sixty-seven votes would be required in the Senate.

Not since Thomas Jefferson has a US president gone this long without using his veto, reports the BBC’s James Coomarasamy.

He says the Bush administration has successfully used pro-life issues to mobilise its Republican base, notably in the ۲۰۰۴ presidential election.

It would be ironic if one of those issues results in the president’s first-ever veto of a Bill passed by the Republican-controlled Congress.

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Study raises malaria block hopes

2008-11-15T13:56:00.002-08:00

Scientists have made a key breakthrough in understanding the genetics of a parasite they hope could be used to block the spread of malaria. The Wolbachia bacterium can manipulate the way insects reproduce so that it is passed down the generations.

Researchers believe a genetically modified version of the parasite could stop insects transmitting the parasite which causes malaria.

The University of Bath study features in the journal Genetics

Malaria kills over a million people a year and is second only to tuberculosis in its impact on world health.

Wolbachia bacteria infect as many as ۸۰% of the world’s insects, including mosquitoes.

They are able to alter the sperm of infected males to prevent them successfully reproducing with uninfected females.

As a result, infected females tend to produce more offspring, which are also infected with the parasite, ensuring it thrives in future generations.

GM insects

Researchers believe it should be possible to use genetically-modified Wolbachia to spread genes that render mosquitoes unable to transmit the plasmodium malaria parasite throughout the insect population.

The Bath team, working in collaboration with the University of Chicago, have identified two of the genes that Wolbachia manipulates when it infects the fruit fly Drosophila simulans.

Researcher Dr Ben Heath said: “This is a major breakthrough in our understanding of the genetic basis of Wolbachia infection.

“In recent years there has been great interest in using transgenic Wolbachia as a way of modifying natural populations of insects such as mosquitoes which transmit malaria.

“However this would always be difficult to achieve without a full understanding of the genetics of how Wolbachia interacts with its host insect.”

Part of the problem in studying Wolbachia is that it lives inside the cells of its host insect, and cannot survive in isolation.

It has also proved difficult to pin down the changes it makes to the development of sperm because they are so subtle they can be difficult to trace.

Sperm changes

The researchers compared the active genes in infected and uninfected male fruit flies to determine which were being switched on as a result of Wolbachia infection.

They identified two genes - zipper and lgl - which they found worked together to change the make up of sperm cells, making it impossible for them to fertilise uninfected eggs.

However, the Wolbachia in infected eggs seems to be able to reverse these changes, rendering the sperm cells fertile again.

The researchers are now looking at the mechanisms present in other insect species.

Dr Pierre Guillet, of the World Health Organization Global Malaria Programme, said the mosquito population had proved itself very adaptive, and responsive to environmental change.

He said there was no guarantee that introducing a specific genetic change would have much impact in a population which was subject to the effects of many other natural selection processes.

“This is very good science, but I must warn against jumping too quickly to optimistic conclusions,” he said.

“What works through in a tube or a mosquito cage is much more complicated in the field.”

Dr Guillet said much more work was needed into the environmental factors controlling malaria spread.

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Drug trial rules ’should change’

2008-11-15T13:56:00.001-08:00

Experts have recommended the rules governing trials of drugs like the one which left six healthy men seriously ill should be tightened. The group, set up by the Health Secretary, has published an interim report on preventing such events.

It said the initial drug dose should be given to just one person - which was not the case in the London trial.

And it recommends drugs which affect the immune system may be best given to people who are already ill.

The trial of the drug TGN ۱۴۱۲, designed to treat rheumatoid arthritis, leukaemia and multiple sclerosis, was created by the German company TeGenero, which has since filed for insolvency.

The trial was carried out by Parexel, at its offices at Northwick Park hospital in north London.

All six men who were given the drug suffered multiple organ failure.

One, Ryan Wilson,۲۰, who was the most seriously affected, still faces the possibility of losing all of his toes and some of his fingers.

Wider issues

The Expert Scientific Group, led by Professor Gordon Duff said its recommendations applied to trials involving drugs such as monoclonal antibodies - of which TBN ۱۴۱۲ is one.

Antibodies are produced in the body in response to infection. Monoclonal antibodies are made in the lab - and some are already on the market being used safely and effectively.

The group’s report also called for more dialogue between the drug developer and regulator when dealing with high risk drugs, and better international sharing of data on serious adverse reactions.

Professor Duff said: “Clinical trials in general have an excellent safety record, but in the light of the TGN ۱۴۱۲ incident there is a need to look at the future safety of clinical trials involving novel and potentially higher risk drugs

“Our interim report provides proposals for the future authorisation of trials involving these types of products and to further improve safety.

“Clearly the Northwick Park incident has informed the work of the group but this is not a further investigation into the incident.

“It is about the wider issue of such clinical trials and about ways to ensure that this type of trial is safe and effective for the future.

A drug industry group - made up of the Association of the British Pharmaceutical Industry and the BioIndustry Association - submitted its own recommendations to the expert group.

It suggested giving just one subject the active medicine on the first day, and then giving “staggered” increased doses to others so it is possible to closely monitor side effects.

Such studies should also be carried out at hospitals with intensive care facilities, they recommended.

Auriana Griffiths of Irwin Mitchell, the law firm representing Ryan Wilson and Mohamed Abdelhady - another of the men involved in the trial, said: “I am pleased that the report has set out a number of very sensible and vital recommendations to help protect the safety of participants in clinical drug trials.”

Dr David Glover, an independent consultant to industry and a member of ABPI/BIA taskforce, said: “The group’s report has come up with some sensible recommendations for the future.

“In particular it has acknowledged that there are more appropriate methods to set the starting dose for the first trial than was used for TGN۱۴۱۲ , and that if those methods had been used a much lower starting dose would have been used.”

‘Unexpected effect’

Health Minister Andy Burnham said a public consultation would take place before the group’s final report was published.

In an earlier report, the Medicines and Healthcare products Regulatory Agency said Parexel - who deny any wrongdoing - failed to follow proper administrative procedures in carrying out the trial.

The MHRA also said the drug was given in the correct doses and there was no sign of contamination or manufacturing errors.

But the MHRA, which sanctioned the trial, said the effects on the men were the result of an “unexpected biological effect”.

It recommended then that a “precautionary approach” should be taken in future trials of drugs like TGN۱۴۱۲.

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Smoking ‘reduces alcohol effect’

2008-11-15T13:55:00.001-08:00

Having a cigarette while drinking may reduce the effects of the alcohol, scientists suggest - but the tests have only been carried out on rats so far. Researchers in the US state of Texas blood-tested rats after feeding them varying doses of nicotine and alcohol.

They believe lower alcohol levels found in “smoking” rats are explained by how alcohol is absorbed into the blood.

But if the same is true in humans, they warn it means smokers are likely to drink more and suffer related problems.

Writing in the journal Alcoholism: Clinical and Experimental Research, the scientists explained their theory on why the level of alcohol in the rats’ bloodstream fell as their nicotine level increased.

They believe the effect may be occurring because nicotine somehow delays the movement of alcohol into the intestines - a major site for the absorption of alcohol into the bloodstream.

While being held in the stomach, the alcohol molecules are metabolised, leaving less alcohol to pass from the stomach to the intestines and into the blood.

Disease risk

Wei-Jeun Chen, lead researcher and associate professor of neuroscience at Texas A&M Health Science Center, warned that smoking and drinking often go together.

He said: “Since the desired effect of alcohol is significantly diminished by nicotine - particularly among heavy or binge drinkers such as college students - this may encourage drinkers to drink more to achieve the pleasurable or expected effect.

“In other words, cigarette smoking appears to promote the consumption of alcohol.”

Susan Maier, health administrator at the US-based National Institutes of Health, said the breakdown of the alcohol could lead to increased levels of toxic alcohol by-products in the body.

She said: “This would be particularly harmful for adolescents and young adult drinkers, since these populations are amenable to this type of drinking pattern, and may develop chronic alcohol-related diseases earlier in life because of it.”

Dr David Ball, a senior lecturer at the Institute of Psychiatry in London, said: “This is a really interesting study. I’m surprised nobody has done it before.

“Obviously, this is a rat study rather than a human study. The most important thing would be to see if this holds true in humans, then we need to see what the implications are.”

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Protein link in study of diseases

2008-11-15T13:53:00.000-08:00

A protein dubbed the “fat controller” could offer new hope in treating cystic fibrosis, according to scientists. Researchers at the University of Dundee have uncovered a link between cystic fibrosis, cancer, diabetes and obesity.

Cystic fibrosis (CF) is a genetic disease that affects organs by clogging them with a thick sticky mucus.

Dr Anil Mehta said the findings could improve the effectiveness of treatment for patients who suffer from the diseases.

Cystic fibrosis disrupts the way the digestive and respiratory systems work. It prevents the pancreas from playing its vital role in helping to break down food.

The disease affects mainly children and young people and a baby can only develop it if it inherits two copies of the faulty gene, one from each parent.

Dr Mehta’s research team studied the relationship between three cancer-related enzymes associated with diabetes (NDPK), fat metabolism (AMPK) and cystic fibrosis (CFTR).

They discovered a new pathway between the cancer and fat metabolism enzymes, which they have dubbed the “fat controller”.

These enzymes also bind to a protein that causes cystic fibrosis.

The researchers believe their work could have a significant impact on treatment of cystic fibrosis, adult-onset diabetes and some forms of childhood cancer.

Weight loss

Dr Mehta, who has worked in cystic fibrosis research for ۲۰ years, said the findings were an important step in producing more effective treatment for patients.

“It has long been known that cystic fibrosis patients suffer significant variations in weight - they tend to be very thin and can suffer very fast weight loss when they fall ill, but we did not know why this was the case,” he said.

“Similarly, it has been known that CF patients suffer a higher rate of cancer than normal and again we did not know why.

“In equal measure, almost half of these patients develop an unusual form of diabetes.

What our research has uncovered are the genetic links, through this cellular fat controller, which we believe lead to these differences in fat metabolism and cancer. Furthermore, there are also significant links here to diabetes.”

Dr Mehta said the findings could have an important impact on future treatment and patients’ life expectancy.

The breakthrough offers hope for cystic fibrosis sufferers like ۱۲-year-old Ashley Parlane, who attends Tayside Children’s Hospital every two months for treatment.

Her mother Shona said she was encouraged by Dr Mehta’s findings.

“The smallest move makes such a big difference to our lives,” she said.

“Emotionally, physically and in every other way it brightens up your day thinking that something could be round the corner.”

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Stronger beds for obese patients

2008-11-15T13:52:00.000-08:00

A hospital is spending hundreds of thousands of pounds on reinforced beds and strengthening mortuary slabs due to an increasing number of obese patients. The Norfolk and Norwich University Hospital said standard beds are not strong enough to hold some people.

It has begun a £۲۰۰,۰۰۰ project to refurbish its mortuary including bigger storage spaces needed for obese people.

Hospital spokesman Andrew Stronach said the situation highlighted the obesity problem currently affecting the NHS.

Cremation facilities

He said: “I think this situation highlights a growing public health epidemic over people’s weight, particularly in cases of morbid obesity.

“It is a considerable issue, not only in terms of people’s health but with the cost to the health service.”

The news comes two months after a Norfolk family was told their dead mother could not be cremated in her home city because she was too large.

Penelope Stapleton from Norwich, who weighed ۲۲ stone, died of a heart attack aged ۶۱.

Her coffin was too large for the facilities at Norwich’s Earlham crematorium and the family was forced to arrange a cremation ۱۲۰ miles (۱۹۳km) away in Watford

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Denmark ‘happiest place on earth’

2008-11-15T13:50:00.000-08:00

If it is happiness you are seeking a move to Denmark could be in order, according to the first scientist to make a world map of happiness. Adrian White from the University of Leicester in the UK used the responses of ۸۰,۰۰۰ people worldwide to map out subjective wellbeing.

Denmark came top, followed closely by Switzerland and Austria. The UK ranked ۴۱st. Zimbabwe and Burundi came bottom.

A nation’s level of happiness was most closely associated with health levels.

WORLD MAP OF HAPPINESS

Happiness map (۱۴۶KB)

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Wealth and education were the next strongest determinants of national happiness.

Mr White, who is an analytic social psychologist at the university, said: “When people are asked if they are happy with their lives, people in countries with good healthcare, a higher GDP [gross domestic product] per captia, and access to education were much more likely to report being happy.”

He acknowledged that these measures of happiness are not perfect, but said they were the best available and were the measures that politicians were talking of using to measure the relative performance of each country.

He said it would be possible to use these parameters to track changes in happiness, and what events may cause that, such as the effects a war, famine or national success might have on the happiness of people in a particular country.

Measuring happiness

He said: “There is increasing political interest in using measures of happiness as a national indicator in conjunction with measures of wealth.

“A recent BBC survey found that ۸۱% of the population think the government should focus on making us happier rather than wealthier.

“It is worth remembering that the UK is doing relatively well in this area, coming ۴۱st out of ۱۷۸ nations.”

HOW THE NATIONS RANKED ON HAPPINESS

۱st - Denmark

۲nd - Switzerland

۳rd - Austria

۴th - Iceland

۵th - The Bahamas

۲۳rd - USA

۴۱st - UK

۹۰th - Japan

۱۷۸th - Burundi

He said he was surprised to see countries in Asia scoring so low, with China ۸۲nd, Japan ۹۰th and India ۱۲۵th, because these are countries that are thought as having a strong sense of collective identity which other researchers have associated with well-being.

“It is also notable that many of the largest countries in terms of population do quite badly,” he said.

He said: “The frustrations of modern life, and the anxieties of the age, seem to be much less significant compared to the health, financial and educational needs in other parts of the world.”

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Surgical tool trade ethics fears

2008-11-15T13:49:00.000-08:00

The purchase of surgical equipment should be bound by the same fair trade rules as foodstuffs like coffee, sugar or bananas, a researcher suggests. Dr Mahmood Bhutta said he had anecdotal evidence there was exploitation of workers in developing countries.

In the British Medical Journal, the ear, nose and throat doctor said it was down to purchasers such as the NHS to press for fair trade.

The Department of Health said buying equipment was down to NHS trusts.

But Dr Bhutta said no systematic investigation had been undertaken into the sourcing of healthcare goods from developing countries.

Pakistan and Malaysia are centres for surgical instrument manufacturing.

Dr Bhutta, whose family comes from the Sialkot area of Pakistan - a centre for instrument making - has interviewed a number of workers and focussed on issues relating to global health and medical ethics.

He wrote in the BMJ: “When surgical instruments have come from manufacturers in the developing world then, as is the case with other goods, the trade may be open to the exploitation of power by transnational companies, driving down prices and labour standards.”

The global trade in hand-held stainless steel surgical instruments was worth at least £۳۵۲m a year, he added.

Child labour

In developing countries, much of the early stage of manufacture - forging, filing, grinding - is subcontracted out to workers employed in a small workshop or their own home.

Manual labourers are paid per instrument, and Dr Bhutta said workers often earn just $۲ a day, with no job security, medical insurance or education for their children.

He highlighted past research which has shown many subcontracted workers in developing countries are children.

Only finishing and quality checks are carried out by companies in-house.

Dr Bhutta added: “When these goods have come from manufacturers in the developing world then, as is the case with other goods, this trade may be open to the exploitation of power by transnational companies, driving down prices and labour standards.

“The scale of such abuse is difficult to ascertain, because we usually do not know or do not ask where our healthcare products are manufactured or sourced.

“The trade in surgical instruments is open to unethical sourcing because many such instruments are manufactured in the developing world.

“This is rarely brought to the attention of end purchasers and consumers.”

‘No assessment’

He added: “The solution lies in purchasers insisting on fair and ethical trade when sourcing instruments.

“Pressure must be applied to suppliers in the developing world to be transparent about where their instruments have been manufactured and for them to ensure that the labourers have been paid a fair wage and that international labour and health and safety standards have been followed.”

He said the NHS Purchasing and Supply Agency had developed a sustainable development policy, part of which encourages NHS suppliers to ensure compliance with international labour standards.

But he said there was no systematic assessment of products’ origins or production conditions.

A spokesman for the Department of Health said: “The purchasing of equipment is a matter for individual trusts.”

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Dark skin ‘does not block cancer’

2008-11-15T13:47:00.000-08:00

Contrary to common perception, people with dark skin are more likely to die from skin cancer than those with fairer skin, warn US researchers. Although the disease is less common, when it does occur it is typically more aggressive and diagnosed later, which leads to more deaths, they explain.

The Cincinnati University work is a warning to anyone who wrongly assumes skin tone makes some immune to cancers.

Experts advise people of all races to protect their skin from sun damage.

Misconception

Lead researcher Dr Hugh Gloster said: “There’s a perception that people with darker skin don’t have to worry about skin cancer, but that’s not true.

“Minorities do get skin cancer, and because of this false perception most cases aren’t diagnosed until they are more advanced and difficult to treat.

“Unfortunately, that translates into higher mortality rates.”

He said it was true that the extra pigment in darker skin did afford some added protection against the sun’s harmful UV rays and that darker skin is, therefore, less susceptible to sunburn.

But he said this should not lull people with darker skin into a false sense of security.

Dark skin has increased epidermal melanin which provides a natural skin protection factor (SPF) - a measure of how long skin covered with sunscreen takes to burn compared with uncovered skin.

Very dark, black skin has a natural SPF of about ۱۳ and filters twice as much UV radiation as white skin, for example.

Sun protection

However, health experts advise people to use sunscreen with an SPF of at least ۱۵.

Dr Gloster told a meeting of the American Academy of Dermatology in San Diego that doctors should make sure that all of their patients, regardless of race, use sunscreen and self-check for skin cancers.

Malignant melanoma, the most aggressive form of skin cancer, can present differently in different races.

Fairer-skinned people may notice a change in a sun-exposed mole, whilst darker-skinned people might develop the cancer on areas protected from the sun such as the soles of the feet.

There are over ۷۰,۰۰۰ new cases of skin cancer diagnosed each year in the UK, making it the most common type of cancer.

Ed Yong, cancer information officer at Cancer Research UK, said: “This study shows that even people with darker skin need to be aware of the signs of skin cancer.

“Although those most at risk of skin cancer are people with fair skin, lots of moles or freckles or a family history of the disease, it is also important for black people to check their skin regularly.

“Black people are most likely to develop skin cancers on the palms of their hands or the soles of their feet.

“Checking your skin for unusual changes is crucial as it can mean that the disease can be spotted earlier, when it is easier to treat.”

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Call to label hidden fats in food

2008-11-15T13:44:00.000-08:00

Food labels should list “hidden” fats to help reduce coronary heart disease, according to scientists. Trans fats, the solid fats found in some processed foods, boost “bad” cholesterol levels, increasing the risk of heart disease.

The Oxford team says labelling trans fats content, as well as saturated fats and cholesterol, will enable consumers to make healthier food choices.

The article is published in the British Medical Journal.

Trans fats, also called trans fatty acids, occur naturally in small amounts in dairy products and meat, but are also formed by a process called partial hydrogenation, which is used to extend the shelf-life of processed food.

They can be found in margarines, biscuits, cakes and fast foods.

The authors, from the University of Oxford, point to recent US research that revealed a ۲% increase in the energy intake from trans fats was associated with a ۲۳% rise in the occurrence of coronary heart disease.

The Oxford researchers have concluded that consumers should be able to see the amount of trans fats in their foods.

Dr Robert Clarke, honorary consultant in public health at the University of Oxford, said: “It is difficult for the layman to make informed choices about what he or she eats if they do not know what is in their food.”

EU changes

In the UK, the nutritional information posted on food labels is at the discretion of the food manufacturer, unless a specific nutrition claim, such as “low in trans fats”, is made.

Most choose to provide some data, and some companies list the level of trans fats, including Sainsbury’s, Nestle and Unilever.

A review of an EU directive that governs the content and format of nutrition labels is under way, and this may change the current regulations.

But Dr Clarke said: “Experts feel this discussion is getting nowhere.”

He suggested the UK undertakes a similar approach to labelling fats as the US Food and Drug Administration’s scheme, implemented in ۲۰۰۶.

He said: “The American model of including the saturated fat content, the trans fats content and the dietary cholesterol level seems appropriate and allows the consumer to make a choice about what they eat.

“It is all about trying to introduce a change that affects a minority of foods that could have a significant impact on the LDL cholesterol, which in turn influences risk of heart disease.”

‘No nutritional value’

A spokesman from the Food Standards Agency said: “The agency recognises the need to improve the labelling of trans fats in foods and is pressing for changes at European level when the Commission publishes a new proposal.”

Dr Mike Knapton, of the British Heart Foundation, said countries such as Denmark had banned the use of trans fats in products without any discernable impact on the consumer.

“Given that they are bad for you, we can replace them, and they have no nutritional benefit, it seems sensible to try to give the public information about which foods contain trans fats.

“There is no need to have trans fats in our diet at all.”

A spokesman from the Food and Drink Federation said: “Consumers can be reassured that food manufacturers are already cutting trans fats in food.

“Manufacturers are fully committed to reducing the level of trans fats to as low as is technically possible.”

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Thailand records bird flu death

2008-11-15T13:42:00.000-08:00

Thailand records bird flu death

Thailand is one of the world’s largest chicken exporters

A ۱۶-year-old boy in Thailand has died of bird flu, local officials have said. The teenager, from the northern province of Pichit, is the ۱۵th person to die of the virus in the country and the first fatality this year.

Officials in Pichit recently confirmed Thailand’s first outbreak of the virus among poultry for eight months.

Globally, more than ۱۳۰ people have died of bird flu since late ۲۰۰۳. Most have been in East Asia, but the virus has also spread to Europe and Africa.

Millions of birds across the world have died or been culled because of the disease.

At the moment, the virus is essentially confined to birds and remains hard for people to catch.

But there is a fear that it could mutate to a form which is easily passed from human to human, triggering a pandemic and potentially putting millions of people’s lives at risk.

More cases?

The latest bird flu victim is believed to have caught the virus while helping his father bury dead chickens last week.

“The final lab test confirmed that he died of bird flu,” Kamnuan Ungchusak, the head of the Health Ministry’s epidemiology bureau, told Reuters news agency.

The World Health Organization has yet to confirm the death.

Health officials are closely monitoring three other suspected cases in Phichit, Public Health Minister Pinij Jarusombat said in a statement carried by the Associated Press. The last human fatality in Thailand occurred in December ۲۰۰۵, but in recent weeks there have been warnings that bird flu could be making a resurgence.

Earlier this month, agricultural officials said they were keeping a close watch for possible outbreaks in areas that had been hit by heavy rains and flooding, because the virus can live longer in wet environments.

Last Tuesday they confirmed that the deadly H۵N۱ strain had been found in chickens in Pichit.

Other countries in South East Asia are also struggling to combat bird flu.

Indonesia has registered more human deaths this year than any other nation, and is soon likely to overtake Vietnam as the world’s worst affected country.

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Americans ‘too fat for x-rays’

2008-11-15T13:40:00.000-08:00

Americans ‘too fat for x-rays’

Some scans are unable to penetrate the excess fat

Increasing numbers of Americans are becoming too fat to fit into X-ray machines, US researchers report. The nation’s rising obesity problems mean many citizens are not only too large for scanners but they have too much fat for the rays to penetrate.

Over the past ۱۵ years, the number of failed scans linked to patient obesity has doubled, Radiology journal reports.

The problem is not confined to scanners. UK hospitals have had to make their beds stronger for obese patients.

Sadly, in the UK we are following in their wake

Dr Colin Wayne of the UK’s National Obesity Forum

And airlines are designing aircraft to carry heavier loads because passengers are becoming plumper.

Dr Raul Uppot and colleagues, who work in radiology at Massachusetts General Hospital, had noticed that they were seeing more and more patients whose weight prevented them from having medical scans.

He and his team decided to look back at radiology reports between ۱۹۸۹ and ۲۰۰۳ to see the extent of the problem.

Missed diagnoses

Year on year they saw a small but significant increase in the number of scans that had to be abandoned because the patient was too fat.

Ultrasound images were affected the most because the sound waves need to penetrate the skin and fatty tissue before reaching the organs being examined.

The study authors warned that important diagnoses could be missed if people could not be scanned.

The US government says ۶۴% of the population are overweight.

Dr Colin Wayne of the UK’s National Obesity Forum said the UK was showing a similar trend.

“The obesity rates in the US have been going up relentlessly. Sadly, in the UK we are following in their wake.

“The UK is now the fastest growing country in Europe for rising obesity.

“It’s worrying if people can’t get the necessary investigations. But that is just the tip of the iceberg. It is the epidemic of cardiovascular and metabolic diseases that will follow in the wake of obesity that is even more worrying.”

Professor Adrian Dixon of the Royal College of Radiologists said: “It is a real problem and it is getting worse. People are getting fatter.”

“One may not be able to offer the obese patient the best possible imaging test because of their weight,” he added.

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Agent Orange ’caused gene damage’

2008-11-15T13:39:00.001-08:00

New Zealand troops who served in the Vietnam War suffered significant genetic damage from exposure to Agent Orange, a study suggests. The chemical was used by the US military in Vietnam in the ۱۹۶۰s.

It has been blamed for a variety of medical conditions suffered by soldiers and up to four million Vietnamese.

The study by New Zealand’s scientists could have a big effect on campaigners’ efforts to sue major chemical firms and the US government, correspondents say.

Highly toxic

The US military sprayed some ۸۰m litres of Agent Orange on North and South Vietnam.

The aim was to destroy jungle foliage in order to find communist fighters more easily.

Agent Orange contained highly toxic dioxins which have since been blamed for causing cancers and other illnesses.

They have also been blamed for birth defects suffered by the children and even grandchildren of Vietnam veterans and Vietnamese civilians.

This has been strongly contested by the two main companies which made it - Dow and Monsanto - and the US government, the BBC’s Bill Hayton in Hanoi says.

A team from New Zealand’s Massey University has now shown that the group of ۲۴ Vietnam veterans it tested suffered significant genetic damage, compared with a similar sized group of soldiers who did not serve in Vietnam, our correspondent says.

This may be crucial evidence in the lengthy legal battles still being waged in courts in the US and other countries to prove or disprove the link between Agent Orange and a legacy of illness across three continents, our correspondent says.

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Agent Orange ’caused gene damage’

2008-11-15T13:39:00.000-08:00

It has been blamed for a variety of medical conditions suffered by soldiers and up to four million Vietnamese.

The study by New Zealand’s scientists could have a big effect on campaigners’ efforts to sue major chemical firms and the US government, correspondents say.

Highly toxic

The US military sprayed some ۸۰m litres of Agent Orange on North and South Vietnam.

The aim was to destroy jungle foliage in order to find communist fighters more easily.

Agent Orange contained highly toxic dioxins which have since been blamed for causing cancers and other illnesses.

They have also been blamed for birth defects suffered by the children and even grandchildren of Vietnam veterans and Vietnamese civilians.

This has been strongly contested by the two main companies which made it - Dow and Monsanto - and the US government, the BBC’s Bill Hayton in Hanoi says.

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BBC :Beirut classrooms become clinics

2008-11-15T13:30:00.001-08:00

By Martin Patience
BBC News, Beirut

Over ۸۵,۰۰۰ refugees are staying in Beirut’s public schools

As a team of doctors wiped down school desks with pungent disinfectant, a group of women with babies in their arms jostled at the classroom door.

“Just wait a minute,” one of the doctors called to the mothers as he carried a brown box of pharmaceuticals over to the window sill.

With Arabic grammar scrawled on the blackboard this does not look like a doctor’s clinic - but that is what it is.

Lebanon’s social services are overwhelmed after up to a million Lebanese fled from their homes in the south of country and Beirut’s southern suburbs as the Israeli bombardment of these areas continue.

Over ۸۵,۰۰۰ of these people are staying in public schools in Beirut. There are power cuts and water shortages in many of the buildings. Often ۲۰ people or more are sleeping in the same classroom.

‘Stress of war’

But for some of the refugees the biggest worry is lack of access to medical care in hospitals and clinics in the city.

In Beirut, a team of about ۵۰ doctors, trainee doctors, pharmacists and nurses from the American University Hospital are volunteering to rounds of ۱۲ local schools to help those most at need.

Dr Faysal Kak, a gynaecologist and co-ordinator of the programme, says that some of the patients are suffering ailments brought on by the stress of war.

Dr Kak says the crisis has taught him a lot about the Lebanese

“We would expect to see people suffering from ulcers, diarrhoea, skin rashes, anxiety attacks and suffering,” he said, before remonstrating a man for wandering into the classroom with a lit cigarette.

Other patients at the Zihaya Kudra secondary school are suffering from pre-existing problems such as heart or breathing problems, says Dr Kak, but their conditions have been exacerbated by their living conditions.

These serious cases are often referred to the hospital.

Inside the classroom, three green mattresses were laid beside the blackboard to be used for examinations. Over ۲۰ boxes with syringes and other medical equipment and pharmaceuticals sit on the desks.

‘Strong, dynamic country’

Doctors work briskly with their patients. One man was told that he had an ulcer and was given appropriate medicine. A woman brought in her young daughter for a check-up.

The young girl, with blonde tints in her hair, screamed as the doctor pulled up her T-shirt and placed the stethoscope on her stomach. She was given the all-clear.

Other classrooms across the city have been turned into clinics

“The [Lebanese] civil war has taught us many things and this country has a very active society,” said Dr Kak, standing in the dingy corridor outside the classroom. “There is a very strong and dynamic country that is able to cope with emergencies like this.”

To prove his point, in another classroom children from six months to nine years old are being vaccinated against measles and polio.

Around the corner, another team of doctors from the same hospital are treating patients living at the al-Huda school.

A young baby is sprawled on a mattress placed on a table as a doctor checks her ears with a small torch.

Outside the sweltering classroom, Ghassan Talib, ۳۱, has just had a check-up for a sore throat.

He praises the doctors for doing a great job by coming to the school. Mr Talib is also happy that his sore throat is nothing serious. It probably has something to do with the three packets of cigarettes he smokes daily.

“But the situation makes me smoke more,” he said.

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BBC :Beirut classrooms become clinics

2008-11-15T13:30:00.000-08:00

By Martin Patience
BBC News, Beirut

Over ۸۵,۰۰۰ refugees are staying in Beirut’s public schools

As a team of doctors wiped down school desks with pungent disinfectant, a group of women with babies in their arms jostled at the classroom door.

“Just wait a minute,” one of the doctors called to the mothers as he carried a brown box of pharmaceuticals over to the window sill.

With Arabic grammar scrawled on the blackboard this does not look like a doctor’s clinic - but that is what it is.

‘Stress of war’

But for some of the refugees the biggest worry is lack of access to medical care in hospitals and clinics in the city.

In Beirut, a team of about ۵۰ doctors, trainee doctors, pharmacists and nurses from the American University Hospital are volunteering to rounds of ۱۲ local schools to help those most at need.

Dr Faysal Kak, a gynaecologist and co-ordinator of the programme, says that some of the patients are suffering ailments brought on by the stress of war.

Dr Kak says the crisis has taught him a lot about the Lebanese

These serious cases are often referred to the hospital.

‘Strong, dynamic country’

Doctors work briskly with their patients. One man was told that he had an ulcer and was given appropriate medicine. A woman brought in her young daughter for a check-up.

The young girl, with blonde tints in her hair, screamed as the doctor pulled up her T-shirt and placed the stethoscope on her stomach. She was given the all-clear.

Other classrooms across the city have been turned into clinics

To prove his point, in another classroom children from six months to nine years old are being vaccinated against measles and polio.

Around the corner, another team of doctors from the same hospital are treating patients living at the al-Huda school.

A young baby is sprawled on a mattress placed on a table as a doctor checks her ears with a small torch.

Outside the sweltering classroom, Ghassan Talib, ۳۱, has just had a check-up for a sore throat.

“But the situation makes me smoke more,” he said.

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Gene for age-related hearing loss

2008-11-15T13:29:00.001-08:00

Hearing loss in the elderly has been linked to flaws in a specific gene in a study by Dutch researchers. About ۳۷% of Britons aged ۶۱ to ۷۰ and ۶۰% of those aged ۷۱ to ۸۰ - ۶.۵m people - have age-related hearing loss.

The Human Mutation study of over ۱,۲۰۰ people found subtle changes in a gene called KCNQ۴ were more common in those with age-related hearing problems.

The Royal National Institute for Deaf People, which funded the work, said it offered “real hope for treatments.”

Age-related hearing loss is a complex condition, which scientists believe has both environmental and genetic causes.

The most common environmental factor is noise exposure.

Hearing loss makes it difficult for elderly people to communicate with friends and family, and can lead to them feeling increasingly isolated.

There is currently is no way of identifying those at risk or preventing the onset of hearing loss.

‘Piece of the jigsaw’

Scientists already know that a mutation in KCNQ۴ is linked to hereditary hearing loss which happens early in life, regardless of exposure to noise and other environmental factors.

In people with normal hearing, it is expressed in the hair cells of the cochlea where it helps recycle potassium, brought in to trigger a nerve signal to be sent to the brain, back into inner ear fluid.

The University of Antwerp team looked to see if more minor changes in KCNQ۴ could play a part in age-related hearing loss.

The team looked at over ۱,۲۰۰ people aged between ۴۰ and ۸۰.

The researchers tested people’s hearing and then looked at their DNA.

They found that three variations - single letter differences in DNA called single-nucleotide polymorphisms (SNPs) - were seen in people with hearing loss but not in those with normal hearing.

They say more research now needs to identify what effect these genetic spelling mistakes have. Possible explanations include causing a build up of potassium in hair cells, or causing it to be removed too quickly.

Hearing aids

Dr Ralph Holme, the RNID’s Biomedical Research Manager, said: “Many people consider hearing loss as an inevitable part of ageing, rather than a potentially preventable condition.

“This research provides another important piece of the jigsaw in highlighting a gene associated with age-related hearing loss.

“At the moment, there is nothing we can do. People can wear a hearing aid, but that doesn’t prevent their hearing deteriorating.

“This offers real hope that treatments will be found and we are optimistic that in the future people will no longer face the prospect of losing their hearing as they age.”

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Gene for age-related hearing loss

2008-11-15T13:29:00.000-08:00

The Human Mutation study of over ۱,۲۰۰ people found subtle changes in a gene called KCNQ۴ were more common in those with age-related hearing problems.

The Royal National Institute for Deaf People, which funded the work, said it offered “real hope for treatments.”

Age-related hearing loss is a complex condition, which scientists believe has both environmental and genetic causes.

The most common environmental factor is noise exposure.

Hearing loss makes it difficult for elderly people to communicate with friends and family, and can lead to them feeling increasingly isolated.

There is currently is no way of identifying those at risk or preventing the onset of hearing loss.

‘Piece of the jigsaw’

Scientists already know that a mutation in KCNQ۴ is linked to hereditary hearing loss which happens early in life, regardless of exposure to noise and other environmental factors.

The University of Antwerp team looked to see if more minor changes in KCNQ۴ could play a part in age-related hearing loss.

The team looked at over ۱,۲۰۰ people aged between ۴۰ and ۸۰.

The researchers tested people’s hearing and then looked at their DNA.

They found that three variations - single letter differences in DNA called single-nucleotide polymorphisms (SNPs) - were seen in people with hearing loss but not in those with normal hearing.

Hearing aids

Dr Ralph Holme, the RNID’s Biomedical Research Manager, said: “Many people consider hearing loss as an inevitable part of ageing, rather than a potentially preventable condition.

“This research provides another important piece of the jigsaw in highlighting a gene associated with age-related hearing loss.

“At the moment, there is nothing we can do. People can wear a hearing aid, but that doesn’t prevent their hearing deteriorating.

“This offers real hope that treatments will be found and we are optimistic that in the future people will no longer face the prospect of losing their hearing as they age.”

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Alzheimer mice memories restored

2008-11-15T13:27:00.000-08:00

The memory of mice suffering from Alzheimer’s disease has been restored, a study shows. US scientists increased the activity of an enzyme called Uch-L۱ which is involved in memory function.

They then tested the mice and found that they had regained the ability to form new memories.

Writing in the journal Cell, the team said the work was in its early stages, but could help the development of therapies for the debilitating disease.

The scientists used transgenic mice that had Alzheimer’s disease.

Like humans with the condition, the mice had plaques of protein amyloid beta in their brain and damaged synapses (the site where brain cells communicate with each other), and they also suffered from memory loss.

The researchers injected the mice with a substance which boosted levels of the enzyme Uch-L۱.

They then tested the mice’s memory by putting them into a cage where they were exposed to a very mild shock from the cage floor.

Mice with normal memories stay still when they are placed in the cage for a second time, to avoid the shock, whereas mice with Alzheimer’s do not because they cannot remember their first visit.

The researchers found that when they placed the mice with boosted Uch-L۱ levels into the cage, they stayed still like the normal mice.

Dr Ottavio Arancio, an author on the paper from Columbia University’s Taub Institute for Research on Alzheimer’s Disease and Aging, said: “We injected the mice with this enzyme, and we found we were restoring their memories.”

He said further investigation revealed the enzyme also seemed to repair the synapse function of the mice.

Possible therapies

Michael Shelanski, another author on the paper from Columbia University, said: “While amyloid beta is certainly a key player in Alzheimer’s disease - and efforts to reduce it remain a worthy goal - our results show that, even in the presence of the plaque, damage to memory can be reversed.”

The authors propose that the enzyme could be targeted to look for new therapies for Alzheimer’s disease; however they cautioned that the research is in its early stages.

Dr Shelanski said: “While this discovery is very promising, its proven effectiveness is limited to animal models and it will take some time before it could lead to therapies in humans.

“We continue to work towards that crucial goal.”

In an accompanying commentary, Peter Lansbury, a neurobiologist from Harvard Medical School, Massachusetts, said: “Understanding the molecular mechanism of memory is one of the most compelling and complex challenges for the next generation of scientists.

“[The researchers] identify a protein that may be involved in both normal memory function and the type of memory loss characteristic of early Alzheimer’s disease.”

Harriet Millward, deputy chief executive of the Alzheimer’s Research Trust, said: “This is a very encouraging piece of research that could potentially open up a new front in the battle against Alzheimer’s disease.

“It is fair to say though, that at this stage a cure is still a long way off. More research is needed to see if this result could eventually be extrapolated from mice to men.”

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Call to scrap the term ‘asthma’

2008-11-15T13:26:00.000-08:00

The term ‘asthma’ should be abolished because it is incorrect and misleading, claims a leading medical journal. Asthma is not a single disease, but a group of syndromes with different origins and characteristics and so it is best to scrap the name, it says.

In the same edition of The Lancet, researchers report that the prevalence of childhood allergies is increasing worldwide.

And allergic children are more prone to asthma, experts warn.

A collection of disorders

An estimated ۳۰۰ million people live with asthma worldwide. This is expected to increase to ۴۰۰ million by ۲۰۲۵.

Despite effective treatments, asthma deaths account for one in ۲۵۰ deaths globally and there remains a great deal to be known about the group of conditions dubbed asthma, says the Lancet.

Asthma includes a range of different symptoms, such as wheezing, coughing and difficulty breathing.

The underlying cause is inflammation of the airways. But it is not known what triggers this inflammation and why some people develop asthma and others do not.

The Lancet says people with asthma can have a range of different triggers, symptoms and responses to treatment, and the general consensus now emerging is that asthma is unlikely to be a single disease entity.

“Perhaps asthma as a symptom is really only the clinical manifestation of several distinct diseases.

“Rather than confusing scientists, doctors and patients even further, is it not time to step out of the straightjacket of a seemingly unifying name that has outlived its usefulness?” it asks.

What’s in a name?

The word asthma originates from a Greek word that means “to breathe with mouth open or to pant”.

The Lancet claims that the term is too vague and should be abolished.

“Until the ۱۹th century fever was regarded as a disease and maybe in ۲۰, ۳۰ or ۵۰ years’ time we will look back at asthma in the same way,” says the editorial.

Dr Andrew Miller, a spokesman for the British Lung Foundation, said: “The Lancet article raises some interesting points; asthma is indeed a complex ailment.

“But whether this is a good enough reason to abandon a useful name which encompasses a range of symptoms treated in a similar way is not yet clear.”

Professor Martyn Partridge of Asthma UK said lung experts had been debating for some time the same question as that asked in the Lancet editorial.

He said it was important to ensure that “asthma” patients taking part in clinical trials were very carefully characterised, so that management strategies which were proven only in some were not applied to all.

But he cautioned: “It may be dangerous to throw out the existing term for clinical purposes, especially if it ran the risk of consequent undertreatment.

“What is not in doubt is that as a condition or group or conditions it’s a widespread, often serious, but controllable problem.”

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Elderly ‘at risk of drug errors’

2008-11-15T13:24:00.000-08:00

The elderly are at risk of accidentally harming themselves by taking potentially lethal mixtures of medicines, an expert says. Pharmacist Kim Munro, of Aberdeen’s Robert Gordon University, found just ۱۶% of patients were receiving help with taking their drugs.

He surveyed ۶۹۵ people aged ۷۸ to ۸۶ living in sheltered housing.

The poll revealed half were taking more than five different medicines a day, with one in five taking at least ۱۲.

Some ۱۴% of the sample were using highly toxic medicines such as warfarin.

Meanwhile, anti-inflammatory and blood pressure drugs taken by more than half the people had a high risk of side effects.

The survey, presented at the British Pharmaceutical Conference in Manchester, also suggested the risk of making mistakes was increased by frequent changes in elderly people’s medication routines.

One in ۱۰ people reported that their drugs - or instructions on how to take them - had changed at least four times in the last ۱۲ months.

Mr Munro said: “This research proves that elderly people are at risk of being harmed by potentially lethal mixtures of medicines. Most people probably aren’t aware that they are in any danger.”

He added that pharmacists could help ensure patients were taking their drugs properly by carrying out medication reviews.

“Further evaluation of such interventions is absolutely necessary in this area, especially for those people with minimal social support.”

‘Ongoing problem’

Between ۱% and ۲% of hospital admissions are related to adverse drug reactions, many of which involve elderly people.

Jonathan Ellis, policy manager at Help the Aged, said: “This has been a problem for a long time.

“GPs and pharmacists should be giving elderly people more information, as it can be quite confusing when you have lots of pill to take and they are being changed.”

If elderly people ended up in hospital because of adverse reactions, the situation could become more complicated, he added.

“They can get their medication changed, sometimes ending up taking more pills, and if they don’t get the advice they are even more likely to end up having problems.”

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Vegetative patient ‘communicates’

2008-11-15T13:23:00.000-08:00

A patient in a vegetative state can communicate just through using her thoughts, according to research. A UK/Belgium team studied a ۲۳-year-old woman who had suffered a severe brain injury in a road accident, which left her apparently unable to communicate.

By scanning her brain, they discovered she could understand spoken commands and even imagine playing tennis.

They said their findings, published in Science, were “startling”, but cautioned this could be a one-off case.

Five months after her accident, which happened in July ۲۰۰۵, the researchers used functional magnetic resonance imaging (FMRI) to record the woman’s brain activity.

She was diagnosed as being in a vegetative state, which meant even when she was awake, she was unresponsive.

While her brain was being mapped, the researchers asked her to imagine simple tasks, such as walking around her home and playing tennis.

Lead scientist Dr Adrian Owen, a neuroscientist from the Medical Research Council’s Cognition and Brain Sciences Unit in Cambridge, said: “The tasks we chose are based on many years of brain imaging research that shows different areas of the brain are activated when we perform different kinds of tasks.”

‘Indistinguishable’

When the scientists compared her brain activity to that of healthy patients, who had been asked to carry out the same task, they discovered the patterns were “indistinguishable”.

Dr Owen said: “These are startling results.

“It tells us the patient could understand speech, because of course, we asked her to do these things. It also tells us that she is able to perform simple tasks in her head, such as imagining certain scenarios.

“We see this as a proof of principle: we have found a way to show that a patient is aware when existing clinical methods have been unable to provide that information.”

However, he emphasised that this was a single case and people should not assume all patients in a vegetative state were consciously aware.

He said: “All vegetative patients are different: they have damage to different parts of their brains and their chances of recovery are different.”

Fuelling the debate

In an accompanying article in the same journal, Lionel Naccache, of the Cognitive Neuroimaging Unit in France, said: “Despite the woman’s very poor behavioural status, the FMRI findings indicate this existence of a rich mental life.”

He said there was a strong case for assessing other patients using this scanning technique, but he added that it was important not to generalise from one patient.

The finding that vegetative patients may experience awareness of their surroundings will fuel the ethical and legal arguments that surround some vegetative state cases.

Last year, a debate raged in America over whether ۴۰-year-old persistent vegetative state patient Terri Schiavo should be allowed to live or die.

Eventually, following a court decision, her feeding tube was removed on ۱۸ March and she died ۱۳ days later.

Kate Bainbridge, who was initially diagnosed as being in a vegetative state, but who has since recovered and can communicate through a keyboard, said the scanning work was very important. She took part in some scanning experiments from the same team.

She said: “I can remember when I couldn’t respond and it was so scary.”

She added that doctors should never assume that a patient is not aware

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IVF donor sperm shortage revealed

2008-11-15T13:20:00.000-08:00

Almost ۷۰% of fertility clinics either have no access to donor sperm, or find it extremely difficult to obtain, a BBC survey suggests. Specialists say infertile patients are becoming desperate and more resources are needed for campaigns aimed at recruiting donors.

But the government said some clinics had managed to recruit new donors and the rest should follow suit.

Seventy-four of the UK’s ۸۵ fertility clinics responded to the poll.

Fifty of the clinics surveyed said they either had no sperm or insufficient supplies.

Many reported waiting times of at least six months for couples needing donor sperm, and some were having to turn patients away.

‘Outside our control’

Zoe and Colin Veal, from Bristol, are among those who are now unsure whether they’ll be able to have children.

“It was a huge shock when we realised we weren’t going to be able to access treatment,” said Zoe.

She said the couple had considered buying fresh sperm over the Internet, or adopting.

“We don’t really know where we want to go from here, but it’s difficult knowing that the plans you make might not come to fruition because of factors outside your control.”

The Veals both work as children’s nurses and aren’t able to afford the £۵,۰۰۰ price tag for private IVF treatment.

And even if they could, there’s no guarantee that the specialised technique called ICSI - where sperm is injected directly into the egg - would work.

Experts say that new sperm donor recruits started to dwindle in number during the run-up to a change in the law last year, which removed anonymity.

The secretary of the British Fertility Society, Dr Allan Pacey, said: “We are certainly in a crisis at the moment - most clinics are finding it difficult to get enough sperm to treat their patients.

“And in the few cases that patients are receiving treatment, they’re not necessarily getting the choice they once had and are having to accept treatment with the only donor that’s available.

“This is a consequence of the law change and the manner in which it was implemented.

“We made the point that centres needed help and some resources in order to receive donors following the law change - but sadly they’ve been left to their own devices, and now we have a tremendous crisis on our hands.”

‘Vital change’

The Department of Health said some clinics have managed to sign up new donors.

And the BBC survey shows that doctors who are still recruiting have been using some imaginative methods - such as targeting workers in the emergency services.

Mark Jackson made a series of ۱۵۰-mile trips to donate sperm in Manchester last year, and was not troubled by the removal of anonymity.

“I knew this could happen but I think it’ll be out of curiosity more than anything else,” he said.

“I spoke at a conference - and ladies came up to me afterwards, showing me photos of their children, and talking about how they’d needed a sperm donor so they could have a family.

“It makes you feel as though you definitely did the right thing.”

Charities representing donor-conceived people say the change in the law has been a vital measure to bring openness into the lives of adults who were created in this way.

They fought hard to get these rights which, they say, simply put donor-conceived people on a par with those who were adopted and feel a need to contact their biological parents.

Olivia Montuschi, of the Donor Conception Network, said it was more complex than simply saying removing anonymity had led to the shortage of donors, and was also influenced by a change in the type of men thought to be suitable to be donors.

“It is also because many clinics, opposed to the ending of anonymity and unable to believe that the government would actually do it, panicked donors by saying that the law could possibly be retrospective or that donor conceived people would make huge demands on them.

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Anticipation ‘boosts bad memory’

2008-11-15T12:56:00.000-08:00

Anticipating a gruesome or traumatic event makes it more vivid and deeply imprinted in the memory, a study says. Researchers found if people were aware something was going to happen, a key memory-forming part of the brain fired.

The University of Wisconsin-Madison said the findings may have implications in the treatment of conditions such as post-traumatic stress disorder.

The study, based on ۳۶ people, is published in the Proceedings of the National Academy of Sciences journal.

Researchers showed the volunteers symbols before exposing them to a series of gruesome images, such as pictures of mutilated bodies, while linked up to MRI scanners.

The symbols were either neutral or signified that they were about to be shown something gruesome.

Half an hour after being shown the images, the volunteers were quizzed about how well they remember them.

Two weeks later, the volunteers were asked again.

On both occasions, those who had previously been given an indication that gruesome pictures were going to be shown were more likely to remember them.

Anticipation

After studying the MRI scans, researchers found two parts of the brain - the amygdala and hippocampus - were activated during the anticipation stage.

Scientists think the amygdala is associated with the formation of emotional memories, while the hippocampus helps the brain form long-term recollections.

Lead author Jack Nitschke said: “Our study illustrates how the power of expectancy can extend to memory formation as well.

“Just the expectation of seeing something bad can enhance the memory of it after it happens.

“In the future, we could look for ways to dampen that arousal response in patients so that they do not evoke negative memories so easily.”

But psychologists said it could work both ways.

Dr Roderick Orner, of the British Psychological Society, said: “This is an understandable reaction and for some scenarios it is quite plausible.

“But we have also noticed that people can become conditioned to bad things happening.

“For example, if you live in an area where disasters are likely to happen, perhaps a war zone, and that disaster does happen those people may not be as traumatised as people affected in places where disasters don’t happen.”

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Mobile phone users ’stressed out’

2008-11-15T12:52:00.000-08:00

People are becoming addicted to mobile phones, causing them to become stressed and irritable, work suggests. Dr David Sheffield, of the University of Staffordshire, found problem behaviour linked to using a mobile in ۱۶% of ۱۰۶ users who were studied.

In a separate study, to be presented at a conference in Essex later, he found blood pressure was lower in those who had given up using mobile phones.

But operators said mobile phones should be seen as a “liberating” tool.

Researchers quizzed student mobile phone owners about how they used their phone.

Some ۱۶% were found to have problem behaviour linked to using their phone - either lying about how much they used them, becoming irritable after using them or being overly pre-occupied with them.

The result of this was to cause the user stress, Dr Sheffield will tell the British Psychological Society.

The theory was reinforced by tests carried out on ۲۰ mobile phone users before and while giving up their mobile phones.

The results showed once people had started cutting down their mobile phone use, their blood pressure was lower when talking about them than before.

Dr Sheffield will say the findings reflect the way the mobile phone market has grown.

The industry is now worth £۱۳bn in the UK - up a tenth on last year - and a third of all calls are made on mobiles.

Cancer

“Mobile phones have impacted on every aspect of our social world,” Dr Sheffield will say.

“These findings suggest that large numbers use mobile phones heavily and that their use impacts on their lives.”

The warnings come after years of debate about whether mobile phones increase the risk of cancer.

There have been mixed results from studies, although the government-commissioned Stewart report concluded mobile phones did not appear to harm health.

However, expert advice is still to limit mobile phone use as a precautionary measure.

David Pringle, of the GSM Association, the trade body for mobile phone operators, said there were two sides to the argument.

“We would say mobile phones are a liberating tool. You can switch them off so you only need be contactable when you want to be.

“They have given people choice, allowing people to work out of the office, and security.”

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IVF donor sperm shortage revealed

2008-11-15T12:50:00.000-08:00